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Request Hands-On Training with Jamie
Upon completion of training, you will receive a certificate of completion and approval for up to 12 SDMS credits.
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Email
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Your email
Full name
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Your answer
Phone Number
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Your answer
Dates Requested
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MM
/
DD
/
YYYY
Preferred Availability For Training
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Mornings
Afternoons
Weekends
Required
Facility
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Your answer
Facility Address
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Your answer
I am a:
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Sonographer
Physician
Physical Therapist
Nurse Practitioner
Physician's Assistant
Other:
Group Size
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Note: Groups of 5 or more require additional staffing
Your answer
Are you able to host me at your site?
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Yes
No, request a host site
If yes, which type of site?
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Please indicate if hospital, outpatient center, private office, conference room, or other. Include site description. Enter n/a if you are requesting a site
Your answer
Do you have an ultrasound system?
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Yes
No, I need a system
If yes, which Manufacturer and Model?
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Please list the manufacturer and model of any Ultrasound systems available at your site (ie: GE, Phillips, Siemens, Sonosite, Samsung, Mindray, ATL, Toshiba, HP, etc)
Your answer
If no, would you like me to provide the ultrasound system?
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Yes
No
Would you need your musculoskeletal program setup with annotation protocols?
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Yes
No
Which transducers does your system have?
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Select all that apply
12-18 MHZ linear transducer
6-10 MHZ linear transducer
9-10 MHZ curved transducer
3-5 MHZ curved transducer
I do not have an ultrasound system
Other:
Required
Special Interests
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Select all that apply
Shoulder
Elbow
Wrist & Hand
Hip & Thigh
Knee
Lower leg, ankle, & foot
Peripheral nerves
Interventional techniques
Required
Please list additional information to help me customize your itinerary to suit the needs of your practice
*
Your answer
I understand that I may be responsible for Jamie's travel expenses
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Yes
No
How did you hear about me?
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Your answer
A copy of your responses will be emailed to the address you provided.
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