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College of Medicine

SSKL Booking Request Form

This form should take 5-10 minutes to complete.

Confirmation will be sent to this address.
If answered "Yes" to the previous question, please continue to the next question.
By answering Yes, I acknowledge and affirm that the learners who will be using this educational material and engaging in skill practice activities are entirely within their legal scope of practice.*
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In accordance with the the Guidelines for Academic Conduct and Conflict of interest all academic staff members, clinical and adjunct appointees, employees, and non-employees/non-appointees who are involved in the design or implementation of simulation or educational activities in the SSKL are responsible for ensuring that their use of the SSKL does not result in a perceived or actual conflict of interest.

Prior to using the SSKL, academic staff, employees, and clinical/adjunct appointees (those subject to the University Code of Conduct) and/or individuals/organizations who do not have an employment or appointment relationship with the University of Saskatchewan but who are involved in the design or implementation of simulation or educational activities in the SSKL must attest to the following:

  • I have read and understood the University of Saskatchewan Guidelines for Academic Conduct documents

I (on behalf of myself and my organization, if applicable) do not have a relationship with any Interested Person and am not aware of any conflict of interest; OR, I am aware of a conflict of interest and confirm that it has been disclosed by the appropriate academic staff member, employee, or appointee who has received an approved Conflict Management Plan as per the operating standard and which has been shared with the Coordinator of SSKL. I understand that failure to disclose any conflict of interest I am aware of may result in the termination of my booking at the SSKL and related privileges.

Please email any relevant documents to surgical.skills@usask.ca. 

Please ensure that you are not submitting confidential or sensitive information.