LIVE Virtual Weekend Attendee Information Form: 2024 SDEP® Abdomen Lab - May 17-19, Andover, NJ | SonoPath

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)

Any additional credentials you would like add:

Corporate Affiliation(Required)

Please use NA if you do not have a corporate affiliation.

Company Name(Required)

Address(Required)

City(Required)

State(Required)

Postal Code(Required)

Mobile Phone Number(Required)

Let us know a little bit about you

Will you be scanning with a partner?(Required)

No – Only myself

Yes – I have a colleague scanning with me

If yes, please add the name of your colleague?

Are you familiar with the SDEP® Abdomen 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 Lab with SonoPath

Previous LIVE Virtual Lab with SonoPath

SDEP® Abdomen online virtual course on SonoPath Education

Other

Tell us about your current ABDOMINAL ultrasound level so we can tailor our teaching to your needs.(Required)

I am a Beginner – I’ve barely done any scanning

I am intermediate – I get most organs, but have trouble with adrenals and high-end views

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

Other

What do you hope to achieve from the LIVE Virtual wet lab sessions?(Required)

What specific areas would you like to be addressed in the wet lab?(Required)

What topics are you most interested in learning about during the pathology lectures?(Required)

What brand is your Ultrasound machine?(Required)

What model is you ultrasound machine?(Required)

Put NA if you don’t know the model.

If other, please list your ultrasound machine here.(Required)

What probes will you be using? (provide the specific names)(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

Would you like to set up a FREE telemedicine account with SonoPath for after lab support and diagnostic reports?(Required)

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 SonoPath NinjaSP

I am interested in acquiring more probes

I am interested in a pricing consultation regarding the SonoPath NinjaSP

I have other questions

Please list your questions here(Required)

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

Attended a SonoPath weekend lab before

Have taken an online course with SonoPath

Google Search

I received an email

Facebook

Linked In

Dr. Lindquist

A friend or colleague told me about it

Other

SonoPath, LLC – Intellectual Property Statement:

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.

SonoPath, LLC – Intellectual Property Statement:(Required)

YES: I agree to the intellectual property statement above

NO: I have questions

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?

LIVE Virtual Weekend Attendee Information Form: 2024 SDEP® Abdomen Lab – May 17-19, Andover, NJ

2024 SDEP® Abdomen Lab LIVE Virtual – May 17-19

Let us know a little bit about you

SonoPath, LLC – Intellectual Property Statement: