Get an ASC Security Code

 Download the ASC Security Code Request Form    icon

 

Each ambulatory surgery center will need a 16-digit security code to log in to the Online Survey Tool on April 1. 

In order to ensure that only authorized individuals have access to the Leapfrog ASC Survey for each facility, a Security Code Request Form must be completed. There are two options for requesting a security code:

Option 1: If your ASC is enrolled in the
NHSN Outpatient Procedure Component

  • Join Leapfrog’s NHSN Group

  • Have the individual listed as the
    “NHSN Administrator” complete
    and sign the Security Code Request Form

  • Print the Security Code Request
    Form on letterhead
  • Submit a request to the Help Desk
    with the required documentation
    in the Attachments field

     
Option 2: If your ASC is NOT enrolled in the
NHSN Outpatient Procedure Component
  • Obtain a copy of the facility’s national
    accreditation letter or certificate, or the
    facility’s county or state business license
  • Have the Facility Administrator complete
    and sign the Security Code Request Form
  • Print the Security Code Request
    Form on letterhead
  • Submit a request to the Help Desk
    with the required documentation
    ​in the Attachments field

Note: If your facility does not have a Facility Administrator as referenced above, the Nurse Manager, Medical Director, or CEO may also submit a Security Code Request Form on behalf of their facility.

Keep the 16-digit security code in a secure location. You will need it to log in, update, and resubmit your Leapfrog ASC Survey.

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