Ultrasound Certificate Program - Enroll
Instructions:
Unless not applicable, all fields are required.
Prefix:
Dr.
First:
MI:
Last:
Suffix/Affiliation:
Address:
City:
State:
Zip:
Country:
Telephone:
Fax:
E-mail Address:
Mailing Address (if different):
Mailing City:
State:
Zip:
Mailing Country:
Telephone:
Fax:
State/National DVM License#:
Location:
Corporate Sponsor:
Select
Aloka
Products Group International
Sound Technologies
Ultrasource
Universal Medical Systems
Independent
Ultrasound Make & Model:
Transducers Available:
Completed Courses:
Basic Abdomen:
Date:
Instructor:
Echocardiography:
Date:
Instructor:
Advanced/Intermediate Abdomen:
Date:
Instructor:
Preferred Format of Case Submission:
(select one)
E-Mail Attachment (JPG)
E-Mail Attachment (JPG, compressed)
Web Submission
CD mailed to IVUSS
Preferred Method of Billing (US Funds):
Check/Money Order
Credit Card via PayPal
Upon enrollment and payment of registration fees, you will receive a start date, deadline for certificate program completion, and a certificate user name and password you can use to check your progress ("My Certificate Program).
I have read and agree to the
terms and conditions
of this Certificate Program
