Survey: SDEP® Ortho, Small Parts & Everything Else - December 1-3, 2023 - Andover, NJ | SonoPath

Survey: SDEP® Ortho, Small Parts & Everything Else – December 1-3, 2023 – 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)

Do you have ANY 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 – 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 area's are you most interested in refining your current ultrasound skills?(Required)

Cardiac – clean up

Shunt Hunt

Small Parts (thyroids, parathyroids, eyes)

Ortho (stifles, shoulders, achilles, psoas and more)

ALL of the above

Signed up for SDEP® Beginner Abdomen wet lab track

Other

What do you hope to achieve from the 3-day SDEP® Everything + Ortho 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)

Yes

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

Yes

What brand is your Ultrasound machine?(Required)

Mindray

Mindray Ninja SP

Esaote

Toshiba

Samsung

Phillips

Hitachi

Fuji

Wisonic

Sonoscape

Other

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

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

Attended a lab before

Google Search

I received an email

Facebook

Linked In

Dr. Lindquist

A friend or colleague told me about it

Would you like information on SonoPath's telemedicine and virtual coaching services?(Required)

Yes

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 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

Would you like to have a quick 10 minute overview of SonoPath.com during one of the lunch breaks to learn how we can support you after you leave the seminar?(Required)

Yes

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 December SDEP® Everything + Ortho Lab weekend 2023. 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.

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?