Forms

    • All program submissions to the ARC/STSA must be created and sent as one seamless PDF file, with all pages upright/facing the same direction, appropriately labeled and bookmarked.
    • The ARC/STSA will not accept or process submissions that are not appropriately bookmarked.
    • Emailed submissions must be sent to info@arcstsa.org
    • For submissions more than 50 pages in length, please contact info@arcstsa.org for submission instructions.
    • Submissions not following the guidelines will be returned to the program for correction and re-submission. Please note that the posted document is to be used as a reference and that not all bookmark labels will apply to your submission.
    • Bookmarks should follow the section label examples for applicable submission type – Self-Study, Findings letter Response, or program change.
    • Please note, attestation forms do not require the submission of additional supporting documentation unless specifically requested by the ARC/STSA.

Surgical Technology Forms

Clinical Forms

Outcomes Tracking & Survey Forms

ARC/STSA Outcomes Tracking Tool

The Outcomes Tracking Tool (OTT) is required for use for tracking ARC/STSA-established outcomes for all cohorts enrolled on or after August 1, 2014. The OTT must be maintained on campus and submitted upon request from the ARC/STSA.

See instructions for completing this form and a sample of a completed form.

ST Graduate Survey Tool

This Graduate Survey Tool is required for use for graduates who completed the program on or after August 1, 2016, and may be administered immediately upon completion of the program.

ST Employer Survey Tool

This Employer Survey Tool is required for use for graduates who completed the program on or after August 1, 2016, and may be administered immediately upon placement.

Curriculum Forms

Non-Core Curriculum Change – Associate Degree

Forms for Core Curriculum for Surgical Technology, 7th edition [CCST-7e]

*Curriculum Attestation Form – CCST-7e

*ST Curriculum Comparison Map-CCST-7e

*Please note evidence of compliance with Standard III.C. Curriculum must be maintained by the program utilizing the Curriculum Comparison Map and be available upon requested by the ARC/STSA.

For curriculum changes falling outside of implementation of the CCST-7e, please contact info@arcstsa.org.

Surgical Assisting Forms

Curriculum Forms

Curriculum Change Packet – Core Curriculum for Surgical Assisting, 4th edition (CCSA-4e)

CCSA-4e Curriculum Attestation Form-SA

*SA Curriculum Comparison Map-CCSA-4e

(*Please note evidence of compliance with Standard III.C. Curriculum should be maintained on the Curriculum Comparison Map and be available when requested.)

Outcomes Tracking and Survey Forms

SASA-ARC/STSA Outcomes Tracking Tool-SA

[required for use for tracking ARC/STSA-established outcomes for all cohorts enrolled on or after August 1, 2014 and upon request by the ARC/STSA]

Click here for instructions for completing this form and a sample of a completed form.

SA Graduate Survey Tool

This Graduate Survey Tool is used for graduates who completed the program on or after August 1, 2016, and may be administered immediately upon completion of the program.

SA Employer Survey Tool

This Employer Survey Tool is used for graduates who completed the program on or after August 1, 2016, and may be administered immediately upon placement.