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)

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 DROP-DOWN MENU

Veterinary Credentials(Required)

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)

Postal Code(Required)

Mobile Phone Number(Required)

Dietary Restrictions?(Required)

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)

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)

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)

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

Yes

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

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

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

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

**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

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)

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)

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?