Program Setup Information
This intake form will allow you to provide us the necessary information to create your program's account with Trajecsys.
It is encouraged that you fill out your intake form after having a Web Tour with our sales team. To request your Web
Tour, please click this link.
Who will be working with us to configure this program?
When would you like students to begin?
When would the first student group graduate?
What is the preferred payment method?
Is this a nursing program?
What is the preferred payment method?
We appreciate the opportunity to show you how our
system can help your program become more efficient,
providing you with more time to meet your students’
educational needs. Please help us collect the information
we need to configure your program for the Trajecsys
Report System™. If you aren't sure how to answer
any of these questions, please go ahead and complete
the form and we'll touch base with you later. You
will be notified when your system is ready for you
to review; this process usually takes approximately
2 weeks, but the time required may vary according
to the number of programs in our setup queue and the
date for which you want to begin testing our system.
What time zone are your clinical sites in?
If you selected Multiple/Other in the box above, please tell us what your zone(s) is.
Also, please list any clinical sites where students may work past midnight.
In our system, students report the procedures that they do each day. They also report their
level of participation (which is configurable by your program). For instance, on one
procedure, they may report that they only observed, while on another, they performed it
with no assistance.
Please list your preferred labels for participation levels. This should contain at least
3 levels, such as 'Observed,' 'Assisted,' and 'Performed,' or 5 levels (such as the three
above with 'Much Assistance' before 'Assisted'and 'Little Assistance' after 'Assisted.'
We can also configure your program to permit clinical instructors to complete competency
exams on students only after the student has done a specified number of procedures at
a specified participation level. If you'd like to use this feature, please complete the two
items below. If you'd like to configure each competency individually or you would not like
to use this feature, just leave this area blank.
Students can report the person who supervised a procedure
and the amount of time the procedure took to perform.
Sonography programs who currently report, or wish
to report, supervising employees to the SDMS for continuing
medical education hours must have these features enabled
for automated reporting.
Please add other instructions or comments to us.
Trajecsys Corporation Policy
Trajecsys Corporation, while taking many precautions to protect your data, cannot guarantee
that data loss, corruption or storage errors will not occur (you will probably not find such
a guarantee with any company). Therefore, we recommend that you regularly back up your
program’s data from our system. We will provide you with one or more methods for doing this,
although the format of your data will not necessarily resemble online formatting via the
Trajecsys Report System™.
Data will be kept for five years from its creation date or until your program discontinues
use of the Trajecsys Report System™. It is your responsibility to save any data prior to
purging. You will be notified before any data is intentionally deleted.
You are free to discontinue use of the Trajecsys Report System™ at any time prior to the
arranged date for the first payment(s) to Trajecsys Corporation at no charge for setup,
testing, or use. Thereafter, your program is free to discontinue the Trajecsys Report System
following notification. Payments already made to Trajecsys Corporation will be refunded
until 30 days after receipt of payment. Payment for system access is due on the date(s)
mutually agreed upon and system access will be denied for non-payment 45 days thereafter
if payment is not received.
Please read the list of other things we'll need and the Trajecsys Corporation Policy
statement, then click the Submit button. We'll confirm that we received the information
from you soon thereafter.
You may call us to discuss any of the selections or
the requested items below at: 1-800-741-7964 ext 9 (Larry Pickett).
We would prefer the information below be forwarded
to us in Excel or MS Word format; pdfs and faxes will
require us to re-key the information which may result
in typographical errors.
Clinical site names (addresses are
Any other evaluations
A list of procedures, broken down
by major areas ( for instance, a major area might
be "Lower Extremity" and include procedures
Ankle, Femur, Foot, etc.). We also need to know which
procedures are mandatory. If you don't specify this,
we'll mark them all mandatory and let you adjust them
later as you wish.
Competency Exam (s). In our system,
all procedures may be associated with the same or
different competency exams. Scoring may differ also.
We will assume that you will provide us with the item
sets for all procedures unless you specify those that
do not need exams.
Please read our policy carefully!
Bookstores can be hard for us to work with. If you
select this option, please review our policy below:
1) Bookstore payment to Trajecsys Corporation is due
in full, for the number of students you have specified,
no later than 30 days from the payment deadline.
2) If partial payment is received, you must notify
us of which students have paid, and all other students
must pay us directly either by check or credit card
from the student payments page of our website within
14 days. If you do not provide us with a list of paid
students, all students marked to have paid through
the bookstore will have Trajecsys Report System access
revoked at that time; otherwise, only students who
have not paid will have access revoked. Students may
NOT pay the bookstore after the deadline, because
we will generate only one invoice to the bookstore.
If they do pay later, they will need to seek a refund,
then pay us directly.
3) If no payment is received from the bookstore by
30 days past the deadline date, we will bill your
program directly with payment due upon receipt. It
will be your responsibility to sort out the issues
with the bookstore and seek reimbursement from them
or from your students; payment from your program is
due within 14 days.
Make sure that you share this information with program
directors or other administrators, as well as all