Participant Contact Form

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New Participants: Select the database(s) you intend to join.
Current Participants: Select your current database(s)
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Physician Representative - (Formerly Known as the Principal Investigator)* is the lead physician (cardiologist or surgeon) responsible for the oversight of data submissions. Only one MD can be assigned the role of Physician Representative.
Site Administrator - Serves as the “point person” for data related inquiries, receipt and distribution of reports and other materials, and audit coordination.
Data Entry Coordinator - The primary person who enters the data into the STS Intermacs database.
Billing Contact - The individual to be invoiced for the calendar year participation fees. A valid mailing address is required. Please provide only one Billing Contact per facility
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