The PRISM™ Program Application

"*" indicates required fields

Welcome to The PRISM Program™, an initiative of The PERT Consortium® designed to unite hospitals worldwide in advancing Pulmonary Embolism (PE) care. From initial team formation to full accreditation and continuous quality benchmarking, PRISM provides institutions with a structured yet adaptable roadmap rooted in collaboration, data, and measurable outcomes. This form will help us determine your institution’s eligibility to participate in this three-year program. Complimentary access will be available to accepted sites for the following initiatives over a three-year period.

Institution Information

Location*
Primary Contact Name*
Do you currently have a formal Pulmonary Embolism Response Team (PERT)?*

Initial Pathway into Program

Please select all pathways your institution is interested in participating in through PRISM*

Data & Infrastructure Readiness

Does your institution have the capacity to consistently input data into the PERC™ Registry? (IRB and DUA required)*

Participation Logistics