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Request Form: 1 on 1 Enriched SDEP® Remote Training
1 on 1 Remote SDEP® Enriched Training
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" indicates required fields
Contact Email
*
Clinic/Hospital contact Email
*
First Name
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Last Name
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Veterinary Credentials
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DVM
DACVIM
DACVR
DABVP
DACVS
DACVSMR
Technician
Not A Veterinarian
DACVAA
DACVD
DACVECC
DACVIM-SAIM
DACVO
DACVP
DACVS-SA
DAVDC
DDA
ABVP
AH
APAC
ARDMS
ARF
BS
BSc
BVSc
CCRP
CCRT
CERP
CVA
CVCHM
CVJ
CVPP
CVT
ECVIM
HBSc
JD
LVT
MBA
MHS
MPH
MRCVS
MS
MSc
NAP
PhD
PT
RDMS
RPG
RVT
VMD
Corporate Affiliation
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Please use NA if you do not have a corporate affiliation.
Clinic/Hospital Name
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Clinic/Hospital Address
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City
*
State
*
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
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Clinic/Hospital Contact Number
*
Let us know about the training you would like:
When are you looking to set up training?
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ASAP
1-3 months
Not sure
What training package are you looking for?
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5 hour package
10 hour package
20 hour package
Not sure yet
All packages include: cameras and any needed software. Schedule an hour at a time for individual learning on specific areas.
Tell us about your current SDEP® Protocol scanning level:
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I am a beginner- I’ve taken my first course in the last 6-8 months, scanning at least 1-3 cases per week
I am intermediate – I’ve repeated courses 1-2 times in the last 2 years, scanning at least 3-5 cases per week
I am advanced – I’ve repeated courses 2-3 times in the past 3 years, scanning at least 5-10 cases per week
What SDEP® Training Lab(s) have you participated in?
SDEP® Abdomen Weekend
SDEP® Abdomen LIVE Virtual Weekend
SDEP® Echo Weekend
SDEP® Echo LIVE Virtual Weekend
SDEP® Abdomen Online Virtual Course
SDEP® Echo Online Virtual Course
Select all that you have attended.
Please let us know the areas you would like to focus on during your training and anything else we should know.
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What brand is your Ultrasound machine?
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M11
SonoPath NinjaSP
GE
Mindray
Esaote
Toshiba
Samsung
Phillips
Hitachi
Fuji
Wisonic
Sonoscape
Other
What model is your ultrasound machine?
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What probes do use with your ultrasound machine?
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Any other questions you have?
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