Webform Current Vendor and Hospital Updates Contact and Role Updates Complete This form allows STS National Database participants to add, deactivate, or update the contacts on file for their institutions. Access STS National Database Forms and Participant Role Descriptions. Please note: New participants must also complete a Participation Agreement and a Business Associates/Data Use Agreement. Learn more about joining the STS National Database. If you wish to move from vendor-based participation to the direct data entry option for the Adult Cardiac, General Thoracic, or Congenital Heart Surgery Databases, contact the STS National Database team at stsdb@sts.org. If you have questions about this form, contact the STS National Database team. Your Name: Your Email: Describe what changes you want to accomplish by submitting this form: Enter your Participant/Site ID# (5 digits starting with a 1 or 3 for ACSD, 4 for GTSD, 5 for CHSD, and 7 for umbrella reports; 4-5 letters for Intermacs or Pedimacs): Enter your Participant/Site ID# (5 digits starting with a 1 or 3 for ACSD, 4 for GTSD, 5 for CHSD, and 7 for umbrella reports; 4-5 letters for Intermacs or Pedimacs): Database Selection Select the Database component for which you are requesting updates. Note: Select one component per form. Adult Cardiac Surgery Database General Thoracic Surgery Database Congenital Heart Surgery Database Intermacs Pedimacs Hospital Name and NPI # Refer to https://nppes.cms.hhs.gov to obtain the Hospital NPI # if needed. Do you need to update the name and/or NPI# of your hospital? Yes No Current Hospital Name: Updated Hospital Name: Current Hospital NPI#: Updated Hospital NPI#: Update Additional Hospital Current Hospital Name: Updated Hospital Name: Current Hospital NPI#: Updated Hospital NPI#: Update Additional Hospital Current Hospital Name: Updated Hospital Name: Current Hospital NPI#: Updated Hospital NPI#: Update Additional Hospital Current Hospital Name: Updated Hospital Name: Current Hospital NPI#: Updated Hospital NPI#: Vendor Software Information Please note: Prior to purchasing a software license, you must have a fully executed Participation Agreement in place with STS. Have you changed your software vendor? Yes No We have stopped using a vendor and now use the Direct Data Entry option. STS will require 7-10 days to process direct data entry transitions for participants with more than 5 data manager updates. STS Certified compliant software vendor name: You must submit the following information prior to harvesting your site’s data, or your data will be rejected. Former STS Certified compliant software used, and dates if known: New STS Certified compliant software vendor name: First submission date software will be used: First surgery date to be included in new software: Leave this field blank
