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2025 SDEP® Abdomen Education Center Attendee Pre-Lab Information Survey- JANUARY
2025 SDEP® Abdomen Education Center – JANUARY
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
DABVP
DACVR
DACVS
DACVSMR
RVT
LVT
ARDMS
Technician
Not a veterinarian
DACVAA
DACVD
DACVECC
DACVIM-SAIM
DACVO
DACVP
DACVS-SA
DAVDC
DDA
ABVP
AH
APAV
ARF
BS
BSc
BVSc
CCRP
CCRT
CERP
CVA
CVCHM
RDMS
CVJ
CVPP
CVT
ECVIM
HBSc
JD
MBA
MHS
VMD
MPH
MRCVS
MS
MSc
NAP
PhD
PT
RPG
Other
Please choose all that apply
Do you have any other credentials you would like to include here?
(Required)
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 any physical limitations that may limit your scanning that you would like to share with us?
(Required)
No
Yes
Example limitations could include carpal tunnel syndrome, shoulder issues, difficulty standing for long periods, etc. We will do everything we can do prepare accommodations so that you may scan in comfort.
If yes, please specify any limitations
(Required)
Please be specific so that we are able to prepare accommodations.
Let us know a little bit about you
Do you currently scan using SDEP®?
(Required)
Yes – I SDEP®
No – I do not use SDEP®, but I currently practice ultrasound
No- I am a complete beginner and have not been taught any scanning.
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® Abdomen online courses on SonoPath Education Network
Other
If no, have you completed any other ultrasound scanning training courses?
(Required)
Yes, I have completed other training
No, I am self taught
Other
If no, have you completed any other ultrasound scanning training courses?
(Required)
Please let us know any other scanning you have been taught.
What is your current ABDOMINAL scanning level?
(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
We use this information to pair you with the correct instructor and learning group in the wet lab.
What do you hope to achieve from the 3-day SDEP® Abdomen Lab?
(Required)
What do you hope to learn from the pathology lectures?
(Required)
Do you currently submit cases to a telemedicine company for evaluation?
(Required)
I currently use SonoPath for telemedicine
Yes, I use another telemedicine company
No, but I am interested in SonoPath telemedicine
No, I am not interested in telemedicine at this time
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 with our Attendee discount?
(Required)
Yes
No
If staying at the Courtyard, would you like to request a seat on the shuttle (from the Courtyard to the Education Center)? Please note, 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
No
**Please note: The shuttle van is only available on the weekend from Friday morning until Sunday.
If using the shuttle van for the weekend, will you need transporation back to the hotel after lectures on Sunday?
(Required)
Yes
No
Lectures on Sunday will conclude approximately at 5:00pm.
Social Media, Video & Photograph Waivers
Please review the permission waivers below for video, recording, photography and usages that may occur during the SDEP® Abdomen 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.
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® Lab weekend. 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.
Do you have any other questions or anything you would like us to know before your weekend with SonoPath?
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