2024 SDEP® Everything Lab Survey DECEMBER

Email(Required)

First Name(Required)

Last Name(Required)

What state is your license issued in?(Required)

What is your license number?(Required)

*Technicians please put N/A

Professional Code(Required)

(Use the following profession codes for this board: Veterinarian=V; Veterinarian Technician=VT) SELECT FROM DROPDOWN!

Veterinary Credentials(Required)

Corporate Affiliation(Required)

Please use N/A if you do not have a corporate affiliation.

Company Name(Required)

Address(Required)

City(Required)

State(Required)

Postal Code(Required)

Mobile Phone Number(Required)

Do you have any Dietary Restrictions?(Required)

This helps guide our weekend catering.

If yes, please specify(Required)

Please be specific with any of your restrictions and or allergies.

Do you have an physical limitations that would limit your scanning abilities, that we should know about?(Required)

In case you may require any support during the lab or lectures, please let us know what this may look like. Example limitations may include: Carpal tunnel syndrome, shoulder issues, standing for long periods at a time, etc.

If yes, please specify(Required)

Please let us know as specifically as you can so that we are able to ensure you are comfortable throughout the weekend.

Let us know a little bit about you

How would you classify your current scanning ability?(Required)

Beginner – I’ve barely done any scanning

Intermediate – I get most organs but have trouble with adrenals and high-end views

Advanced- I readily get organs but would like to improve my efficiency on high end views and clinical approach to pathology

Are you signed up for the Abdomen Track (Beginner) or the Everything, Ortho, & Cleanup Track?(Required)

Abdomen

Everything, Ortho, & Cleanup

What areas are you most interested in refining your current ultrasound skills?(Required)

Cardiac – clean up

Shunt Hunt

Small Parts (thyroids, parathyroids, eyes)

Ortho (stifles, shoulders, achilles, psoas and more)

ALL of the above

What are your goals/objective for your SDEP® lab experience?(Required)

Tell us a bit about what you hope to achieve over the lab weekend.

If the opportunity allows, would you like to scan a cat?

*please note that we work with a local shelter and cannot guarantee any/all attendees will be able to scan a cat.

What do you hope to learn from the pathology lectures?(Required)

Have you ever taken an ultrasound hands-on lab (other than SDEP®) before?(Required)

Yes

If yes, which course have you taken?(Required)

Do you currently submit telemedicine cases for evaluation?(Required)

Yes, I/my company work with SonoPath telemed

Yes, we use another company (not SonoPath)

No, but I am interested in SonoPath Education Telemedicine

No, I am not interested in using telemedicine

Does your practice currently have an ultrasound machine?(Required)

Yes

What brand is your Ultrasound machine?(Required)

M11 (Mindray, exclusive to SonoPath)

Ninja SP (Mindray)

Mindray

Esaote

Toshiba

Samsung

Phillips

Hitachi

Fuji

Wisonic

Sonoscape

Other

Are you looking to upgrade your current ultrasound system?(Required)

Yes

Please select all that apply(Required)

I would like to know more about the M11 ultrasound machine

I am interested in acquiring more probes

I have other questions

Please list your questions here

How did you find out about our ultrasound lab?(Required)

A friend/colleague/word-of-mouth

Google Search

Instagram

Facebook

Received an email

Attended a SonoPath lab/online course previously

Dr. Lindquist

A SonoPath team member

Upon the submission of this form, you will be directed to a page to sign up for a FREE account with SonoPath's Education Telemedicine. We would love see an image set before your lab.(Required)

I hope to submit an image set for quality control (QC) before the lab so I can have “before” and “after” images to track my scanning skills

I do not have an account, but I am excited to sign up today

I am not sure what SonoPath’s Educational Telemedicine is and am hesitant to sign up for the free account

I don’t think I will do this

Will you be staying the Courtyard by Marriot Rockaway/Mt. Arlington with our Attendee discount?(Required)

Yes

If staying at the Courtyard, would you like to request a seat on the shuttle (from the Courtyard to the Education Center)? Please keep in mind, space is limited to the first 10 requests. To ensure a reservation please return this survey promptly. You will be contacted either way to confirm your reservation or to be notified that the shuttle is full.(Required)

Yes

Social Media, Video & Photograph Permission Waivers:(Required)

YES: I hereby give SonoPath, LLC the absolute right and permission to publish images/pictures of me for promotional purposes in which I may be included in whole or in part. I also understand and grant permission to the rights of my image and sound of my voice as recorded on audio or video tape without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published, or distributed.

NO: I do not grant SonoPath, LLC the right or permission to publish images/pictures/recordings of me for promotional purposes in which I may be included in whole or in part.

Please review the permission waivers above for video, recording, photography and usages that may occur during the December SDEP® Everything Lab weekend 2024. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed.

Permission Waiver: Digital Signature(Required)

By checking the boxes above and typing my full name in this field, I acknowledge that I have completely read and fully understand the permission waivers and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational purposes.

SonoPath, LLC – Intellectual Property Statement:(Required)

YES: I agree to the intellectual property statement below.

NO: I have questions

INTELLECTUAL PROPERTY STATEMENT: The content of this course, video and procedures are protected under copyright and other intellectual property laws. Video’s supplied to the attendees and/or education information is ONLY for non-commercial private viewing and individual private use only.

If you answered no, please list your questions here:(Required)

Intellectual Property Statement: Digital signature(Required)

By checking the YES box above and typing my full name in this field, I acknowledge that I have completely read and fully understand the intellectual property statement and agree to be bound thereby.

Do you have any other questions or concerns before you lab that we can assist you with?