*First Name:
*Last Name:
What is your Professional Title?
* Phone Number
*Email Address
* Name of Pregnancy Center(s) you are affiliated with
Affiliated Organization
Address of Organization
City
State
Zip
Executive Director of Organization
*What Organization provided your training? *
*Approximately how many scans do you perform a week? ___month?___
*Do you have an RDMS available to assist you or to consult with?
What is the manufacture and year of your ultrasound system?
Do you understand how to perform all the functions on your ultrasound system to optimize your image?
*What objects for on-line learning are you interested in?
* Acknowledgement of Membership Fee (No payment will be taken at this time) Membership starts on the original date of purchase, and extends from the beginning of the following day - through the end of the day on the same date the following calendar year.

Sound Wave Images, Inc.
Attn: SHARI RICHARD - 6542 Lakeshore Road, Lake Port, MI 48059

© 2024 Shari Richard