Sonographer Checklist

First Name

Last Name

Email Address

Phone Number

How soon are you looking to be placed?

Years of experience

Your Current Situation:

Level of Education:

Where did you receive your training?

Level of Expertise:

Select all that apply to you:

Specialized knowledge of FDA processes protocols development and measurements Specialized knowledge and applications for medical devices and nonmedical devices Specialized knowledge in patient advocacy, chart reviewing for insurance companies, scribing, billing and coding, or epidemiology

Credentials

Leadership Position

Currently scanning in:

acute care private practice outpatient center as a perm as a temp PT FT PRN mobile

Future scanning goals:

acute care private practice outpatient center as a perm as a temp PT FT PRN mobile

Do you currently have a work-related musculoskeletal injury from the use of diagnostic medical ultrasound?

Yes No

Approximately how many hours can you scan before you are symptomatic?

How many years have you been bedside?

Have you ever been involved in education, applications, or advocacy for diagnostic ultrasound? If yes, please briefly explain.

Sonographer Checklist

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