• Only use this form if you are NOT a member of the National Surgical Assistant Association (NSAA) and desire to recertify by CEU Submission
  • Full payment must be submitted along with all CEUs 60 days prior to recertification date
  • If you prefer to recertify by examination, please click here to schedule your exam
  • If you are a Current Member of NSAA, please update your contact information in the Member's Area of the NSAA website

We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

  • Required Documents

    Please submit your form with the following required documents by uploading them below.
  • Accepted file types: pdf, Max. file size: 64 MB.
    Please compile all CEU documents in a single PDF and upload it here.
  • Information

  • Current Employer

  • Education and Training

  • Name of ProgramLocation of ProgramDates AttendedDegree/Certificates Awarded 
  • Previous Employment

  • Fees

    The following fees are associated with your application. Certification application fees are non-refundable.
  • American Express
    Supported Credit Cards: American Express, Discover, MasterCard, Visa
  • $0.00
    Your card will be charged this amount.
    By submitting this form you agree to the rules and regulations and the Ethical Standards of the NCCSA.
    You are bound by the payment policy of the NCCSA.

Submit via MAIL Instructions
If you would like to submit your payment via MAIL, fill it out the form  first, DO NOT CLICK SUBMIT when you are done, and go to File > Print to print what you've filled out. You can them mail in the printout to 1775 Eye Street, NW, Suite 1150, Washington, DC 20006.