Form

Program Inquiry Form

This form is intended for Residency/Fellowship program leadership to express interest and/or request information on purchasing Thalamus products. Please complete the form below with the requested information to receive follow-up from Thalamus. A separate form for DIOs/institutions may be found in the Institution Form. Programs and institutions may complete both forms as needed.

For ERAS® Programs:
ERAS residency and fellowship programs will receive complimentary access to Thalamus Core, Itinerary Wizard, and Cerebellum. Starting in July 2025, Cortex will also be available complementary for ERAS programs for the 2025/2026 ERAS season. Programs may still elect to purchase Thalamus Video for an additional fee.

Regardless of whether or not programs use this form, all participants will be required to formally opt-in to Thalamus by accepting the terms of use in ERAS® Program Management (EPM) starting on April 15, 2024.

For non-ERAS Programs:
Residency and fellowship programs that are not using ERAS for the 2025 season -- but are interested in using Thalamus -- may purchase Thalamus Core, Itinerary Wizard, and Thalamus Video.

If you have a specific question or need support, please submit a Thalamus support ticket.

We are honored to support your recruitment efforts this season, and we can't wait to hear from you!

Sponsoring Institution Name*

First Name*

Last Name*

Program Role/Title

Email*

Phone Number

Program Specialty

ACGME Program Type

Residency

Fellowship

ACGME Program ID*

If you don't know or don't have an ACGME ID, please write "Do not have."

Are you a current Thalamus Customer?

Yes

Thalamus Program ID

Note: Current customers only, located at the top left of your Thalamus Program Profile

I am interested in (select all that apply):*

Cortex - Application screening and review tool promoting technology-assisted holistic review (ERAS programs only)

Thalamus Video - Integrated virtual interview platform

Non-ERAS programs: Thalamus Core or Itinerary Wizard

Complimentary access to Thalamus Core, Itinerary Wizard and Cerebellum (ERAS programs only)

Training Packages

Something else

Referral from (name)

If referred by someone, please provide their name.

Any additional information you would like to share or request?