Alcon Experience Academy

Welcome to the Alcon
Experience Academy

To schedule clinical training at your center, complete the following form and submit to Alcon for processing.

Trainer Requestor Contact Name *

Trainer Requestor Contact Email *

Trainer Requestor Contact Phone Number *

Center Name *

Country *

Street Address *

City *

State / Province *

Postal Code *

Surgery Center Contact Name *

Surgery Center Contact Email *

Surgery Center Contact Phone Number *

Has Surgery Center Been Reserved for the Dates Provided?

Same as Above

Surgery Center Name *

Country

Street Address

City

State / Province

Postal Code

Surgery Center Contact Name

Surgery Center Contact Email

Surgery Center Contact Phone Number

Number of Surgeons to be Trained *

Number of Technicians to be Trained *

Number of Eyes Scheduled *

Alcon requires a minimum of 5 eyes to schedule an Alcon CAS

CAS Hands-on Training Dates (not live surgery)

Surgery Observation Dates (live cases)

Comments