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In this tutorial, we focus on step 5 of NHSN enrollment: signing and faxing the NHSN agreement to participate. First, access the link in the NHSN facility enrollment email received after submitting the long-term care annual facility survey form. You may need to log in to SAMS using your credentials. Print the agreement to participate and consent form. Ensure that the NHSN long-term care primary contact, like the LTCF administrator, and someone from executive leadership sign and date the form (the same person can sign twice). Finally, fax the signed form to the CDC using the fax number provided in the enrollment email. Expect a response within three business days.