JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2022 Southwestern Ultrasound Regional Fellowship (SURF) Conference
Event Timing: August 26, 2022
Event Address: 3800 W Chapman Avenue, Floor 3, Orange, CA 92868 (
MAY CHANGE TO ELSEWHERE ON CAMPUS, EMAIL UPDATES CLOSER TO EVENT WILL CONFIRM
)
Contact us: dasiaesener@gmail.com
COST: NOTHING, ZERO DOLLARS
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Email
*
Your answer
Program (or Hospital if not currently affiliated with fellowship)
*
Your answer
What is your current work/training status?
*
Current fellow
Ultrasound faculty
Recent prior fellow but not in an ultrasound role (community or academic) currently
Resident
Other
If other above, please give us the scoop:
Your answer
Will you attend social function (TBA) the evening before (8/25/22)?
*
Yes
No
Maybe
Other:
Dietary restrictions
*
None
Vegetarian
Vegan
Kosher
Gluten-free
Other:
Phone number (optional but if we need to send out a group message evening before regarding dinner or something, it is helpful)
Your answer
COMMENTS/OTHER:
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
