Attendee Information - SDEP® Echo Lab - March 22- 24, 2024, Andover, NJ | SonoPath

2024 SDEP® Echo Lab – March 22- 24, Andover, NJ

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)

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)

Dietary Restrictions?(Required)

This field is used to help accommodate catering decisions for the lab 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)

Example limitations: Carpal tunnel syndrome, shoulder issues, standing for long periods at a time, 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 with any physical limitation concerns you may have.

Let us know a little bit about you

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

I am a Beginner – limited scanning, do not know what cardiac views are needed, starting from scratch

I am beginner/intermediate – I am familiar with the needed cardiac views and can get most of them most of the time, limited or no experience with measurements and Doppler

I am intermediate – I am fairly confident with my ability to get the needed cardiac views, need refinement on measurements and Doppler

I am intermediate/advanced – I am confident with the needed cardiac views, measurements and Doppler, but need refinement and work on more difficult presentations as well as efficiency

I am advanced – I am very confident with needed cardiac views, measurements and Doppler; I would like to take my current skills to the next level, improve efficiency and my clinical approach to pathology

Other

How long have you specifically scanned hearts?(Required)

Are you familiar with Doppler?(Required)

Yes

Other

Do you currently submit cardiac cases to a telemedicine company for evaluation?(Required)

Yes

If yes, please specify the feedback you may have received. (This information helps us select the correct training group for you)(Required)

What are the primary issues do you wish to work on with echocardiography?(Required)

If the opportunity is available do you wish to have scanning time on a feline?(Required)

Yes

DISCLAIMER: We work with local shelters to provide scanning patients, the availability of felines are not guaranteed.

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

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

Yes

What brand is your Ultrasound machine?(Required)

Are you looking to upgrade your current ultrasound system?(Required)

Yes

I am interested in acquiring more probes

I have other questions

Please select all that apply(Required)

I am interested in learning more about the SonoPath Ninja SP

I am interested in acquiring more probes

I am interested in a pricing consultation regarding the SonoPath Ninja SP

I have other questions

Please list your questions here(Required)

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

Attended a lab before

I received an email

Google Search

Facebook

Linked In

TikTok

I did a SonoPath online course

Dr. Lindquist

A friend or colleague told me about it

Will you be staying the Courtyard by Marriott 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 keep in mind, 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

Permission Waivers and Intellectual Property Statement:

SDEP® Echo Lab weekend 2024 Attendees: Please review the permission waivers below and intellectual property statement.

Social Media, Video & Photograph Permission Waivers:(Required)

YES: 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. I also understand and 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.

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.

Please review the permission waivers above for video, recording, photography and usages that may occur during the SDEP® Echo 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.

Permission Waiver: Digital Signature(Required)

By checking the boxes above and typing my full name in this field, I acknowledge that I have completely read and fully understand the permission waivers 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'd like to let us know? Any Questions?

Attendee Information – SDEP® Echo Lab – March 22- 24, 2024, Andover, NJ

2024 SDEP® Echo Lab – March 22- 24, Andover, NJ

Let us know a little bit about you

Permission Waivers and Intellectual Property Statement: