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2025 February Scan Only Attendee Pre-Lab Form
2025 SDEP® SCAN ONLY February 21 & 22
Email
(Required)
First Name
(Required)
Last Name
(Required)
What state is your license issued in?
(Required)
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UM
UT
VA
VI
VT
WA
WI
WV
WY
International/Other
What is your license number?
(Required)
*Technicians please put N/A
Professional Code
(Required)
V
VT
N/A
(Use the following profession codes for this board: Veterinarian=V; Veterinarian Technician=VT) SELECT FROM DROP-DOWN MENU
Veterinary Credentials
(Required)
DVM
DACVIM
DACVIM-SAIM
ABVP
DABVP
CVT
LVT
RVT
VMD
ARDMS
RDMS
Technician
AH
APAC
ARF
BS
BSc
BVSc
CCRP
CCRT
CERP
CVA
CVCHM
CVJ
CVPP
DACVO
DACVS
DACVS-SA
DACVSMR
DACVR
DACVP
DAVDC
DDA
ECVIM
HBSc
JD
MBA
MHS
MPH
MRCVS
MS
MSc
NAP
PhD
PT
RPG
Not A Veterinarian
Choose all that apply.
Corporate Affiliation
(Required)
Please use NA if you do not have a corporate affiliation.
Clinic/Hospital Name
(Required)
Address
(Required)
City
(Required)
State
(Required)
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MP
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UM
UT
VA
VI
VT
WA
WI
WV
WY
International/Other
Postal Code
(Required)
Mobile Phone Number
(Required)
Dietary Restrictions?
(Required)
No
Yes
This field is used to help accommodate catering for the weekend.
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)
No
Yes
Example limitations: carpal tunnel syndrome, shoulder issues, standing for long periods, etc. We ask this so that we can be prepared for any special accommodations or alternative suggestions for scanning positions that will best accommodate you.
If yes, please specify
(Required)
Please be specific concerning any physical limitation concerns you may have.
Let us know a little bit about you
Are you familar with the SDEP® protocol?
(Required)
Yes – I have been scanning with the SDEP® Protocol
No – I do not use the SDEP® protocol
If yes, where did you receive your training?
(Required)
Previous Hands on SDEP® Lab weekend with SonoPath
Previous LIVE Virtual SDEP® Lab weekend with SonoPath
SDEP® online courses on SonoPath Education Network
Other
Tell us about your current ultrasound level so we can tailor our teaching and wetlab stations to your needs.
(Required)
I am a beginner – I have barely done any scanning.
I am intermediate – I find most organs but have trouble with adrenals and high-end views.
I am advanced – I readily find organs but would like to improve my efficiency with high-end views and clinical approach to pathology
Other
Have you ever taken an ultrasound hands-on lab (other than SDEP®) before?
(Required)
Yes
No
If yes, which course have you taken?
(Required)
What do you hope to achieve from the SDEP® Scan-Only Lab?
(Required)
Do you currently submit cases to a telemedicine company for evaluation?
(Required)
We currently use SonoPath for telemedicine
Yes, we use another telemedicine company
No
Would you like to set up a FREE telemedicine account with SonoPath for after lab support and diagnostic reports?
(Required)
Yes
No
Does your practice currently have an ultrasound machine?
(Required)
Yes
No
If no, would you be interested in the following:
(Required)
I am interested in a free pricing consultation regarding the M11 ultrasound machine
Other
What brand is your Ultrasound machine?
(Required)
M11
Ninja SP
GE
Mindray
Esaote
Toshiba
Samsung
Phillips
Hitachi
Fuji
Wisonic
Sonoscape
Other
What model is your ultrasound machine?
(Required)
Please use N/A if you do not know the model.
Are you looking to upgrade your current ultrasound system?
(Required)
Yes
No
Please select all that apply
(Required)
I am interested in learning more about the M11 ultrasound machine
I am interested in acquiring more probes
I am interested in a pricing consultation regarding the M11
I have other questions
Please list your questions here
(Required)
How did you find out about our ultrasound lab?
(Required)
Attended a SonoPath lab weekend before
Have taken an online course with SonoPath
Google Search
Facebook
Instagram
Linked In
I received an email
Dr. Lindquist
A friend or colleague told me about it
Other
If other, please describe here:
(Required)
Will you be staying the Courtyard by Marriot Rockaway/Mt. Arlington OR the Fairfield Inn as recommended on our travel page?
(Required)
Courtyard by Marriott
Fairfield Inn
Other
Do you require transportation from the Fairfield Inn?
(Required)
Yes
No
Transportation is only available from the Fairfield Inn on Friday morning, Friday afternoon, & Saturday morning. We are able to provide information for drivers or Ubers for Saturday afternoon if required.
Social Media, Video & Photograph Waivers
Please review the permission waivers below for video, recording, photography and usages that may occur during the SDEP® 2-Day scanning Lab 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.
Social Media, Video, & Photograph Waivers:
(Required)
YES, I consent to my photo being taken (see full details below)
NO, please leave me out of pictures (see full details below)
Please review the following permission waivers for video, recording, photography and usages that may occur during the 2025 SDEP® Scanning Lab. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. YES: 1. 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. 2. I hereby also 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. 3. By selecting YES, I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet. 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.
Permission Waiver: Digital Signature:
(Required)
By checking the boxes above and typing my name in this field, I acknowledge that I have completely read and fully understand the releases 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. Any distribution, sharing, copying, teaching, transmission, public performance, alteration, or reverse engineering outside private individual use of purchaser/attendees (unless expressly authorized by SonoPath, LLC) is strictly prohibited and may result in criminal and or civil liability.
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.
Anything else you would like to let us know? Any Questions?
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