Application for ICRS Center of Excellence
Please fill out the following application form if your institute is interested in becoming an ICRS Center of Excellence.Approval Process: Once the application form is submitted, the office will send it to the Education Committee Chair, who, together with the committee members, should analyse the requirements. If the requirements are not fulfilled or there are concerns (e.g., reputation), the Executive Board should be informed and will help make a final
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Website
*
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CLINICAL / RESEARCH CENTER
We are a clinical center
*
Yes
No
We are a research center
*
Yes
No
Both opportunities are available
*
Yes
No
Name of Clinician for Teaching
*
Name of Director of Research
*
In University program
*
Yes
No
Private Practice program
*
Yes
No
Residency/Fellowship Program present
*
Yes
No
Short overview of your program
*
Available training / techniques
*
Foot & Ankle Procedures
Hip Procedures
Shoulder Procedures
Knee Procedures
Fourth Generation ACI
Knee joint distraction
Microfracture
Chondroplasty
Mosaicplasty
OATS
First generation ACI
Second or third generation ACI
Osteochondral Allograft Reconstruction
Meniscus Transplantation
Patello-femoral Realignment/ Reconstruction
Osteotomies
Unicondylar- & Total Joint Arthroplasty of Knee
Non Operative Interventions (including Visco-supplementation)
PRP
Primary language
Secondary language
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APPROXIMATE ANNUAL CASE VOLUME
Arthroscopic knee procedures
*
Arthroscopic hip procedures
*
Arthroscopic foot & ankle procedures
*
Arthroscopic shoulder procedures
*
Number of advanced cartilage repair techniques
*
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OPPORTUNITIES, EXPERIENCES & LOCATION
Available scientific research opportunities
*
Describe your participation in past ICRS educational, hosting or society events
*
Can your center provide free or reduced-cost accommodation through your institute?
*
Yes
No
Nearest airport to your institution
*
Any other important information you would like to add
*
Submit
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