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             Home > www.duerinckx.com                                                      Updated Nov 04, 2007

Cardiovascular Imaging (CVI) Courses
Advanced Cardiovascular CT and MR Hands-on Courses  by Dr Duerinckx

REGISTRATION FORM for Courses
.... we have another form for Visiting Fellows

 

For DATES of FUTURE Courses.. Click here.

  Complete this form, PRINT it and then FAX it to us (and mail your check) to:
       Dr Duerinckx, Attn: Cardiac Education Coordinator,
Department of Radiology
MetroHealth Medical Center
2500 MetroHealth Drive
Cleveland, Ohio  44109-1998

   Call Dr Duerinckx's Office
Metro Radiology Education Coordinator's office
Cindy Frederick at : +1-216-778 4034   (new)
or e-mail RadiologyCourses@MetroHealth.org

Our FAX: +1-216-778 4046
Back-up FAX: 216-778 8593

Look for HOTEL and AIRPORT Info at the bottom of this form

REGISTRATION FORM Cardiovascular CT and/or MRI Course in Cleveland, OH

First Name
         Please carefully read our NO REFUND (but option to exchange) Policy at the end of this Page.
Last Name Degree
Institution
Street Address/Suite
City
State/Province     Postal Code 
Country
Office Phone
Cell phone
Office Phone
Your private cell phone or Beeper/pager
Name of Your Secretary or NAME of person to contact with problems.
e-mail of Your Secretary
Fax
 

E-mail

Indicate if you wish to Pay by CHECK or CREDIT CARD
                              Amount US $

Signature         To Approve Credit card Payment
(Ignore this signature line if you are e-mailing us this form as a .pdf file)

Name (printed) NAME as Printed on Your Credit Card
 BILLING ADDRESS for Credit card   

Type of CREDIT CARD        CREDIT Card Payments
We only accept VISA, Mastercard and DISCOVER Card. We can not accept American Express or other cards. Sorry.
CARD NUMBER                   e-mail this form to us as a .pdf file
Expiration date                   or
AMOUNT                             FAX this form to us

 Send to us via Secure FAX to: ++1-216-778 4046 (FAX)
In case of problems, use Back-up FAX: 216-921 8345 !!!!

 Please make checks out in US Dollars Only. Make checks payable to :
           "MetroHealth, Radiology Education Account"

Please indicate Preferred Date(s) for course(s) :   
      

Jan 18-19, 2008
March 21-22, 2008
May 16-17, 2008

Since Jan 2007 these courses are offered in Cleveland, OH.





Info on DISCOUNT for trainees or Techs

Call us about Special DISCOUNT for
MetroHealth Employees



Make checks payable to :
"MetroHealth , Radiology Education Account"


       Amount of Payment / Check enclosed
US $ ________

Without Late Fee:
New Price:$3,600 for CT Course
Discount of $1,000 for Sept Course
For Residents/fellows !!
Old Price:$2,600 for CT Course
$3,500 for MR Course

PRINT Your Name: _______________________

Please read Disclaimers

During each 2-day course, participants will have extensive exposure to interpretation of coronary CT angiography data sets, including hands-on evaluation of 35 to 50 cases, some with correlation to invasive coronary angiography.

Level I Certificates will be issued after each class (50 cases read) .

Courses based on the ACCF/AHA and ACR Guidelines.

Level 1:These 50 cases read will count towards the "Minimum Number of Mentored Examinations Interpreted" according to the ACCF/AHA Clinical Competence Statement on Cardiac CT and MR (Budoff et al, JACC 46:2005;383-402), which lists 50 cases of mentored examinations interpreted as a requirement for Level 1 training, 150 cases for Level 2 training, and 300 cases for Level 3 training.
Level 2: In addition a few patients will actually be scanned during the 2-day course, and those cases will count towards the "Minimum Number of Mentored Examinations Performed" with patients. The other 50 cases read will count toward the cases (non-direct performance: 100 for Level 2, 200 for Level 3) which must involve interactive manipulation of reconstructed datasets using a workstation, limited to two candidates per workstation.

For information about CME and the Case School of Medicine CME Program (Case) .....please click here to download .

  

DISCLAIMERS:
1) If your class is cancelled or post-poned (due to us cancelling it because of: unexpected faculty illness, equipment failures, fewer than 5 people registering, or another reason) you can either get a REFUND, or be automatically re-registered for the next class. Feel free to contact us at anytime to find out how many people are already registered. However, if you purchased advance air travel and hotel accommodations, you will be responsible for any added travel-related costs in case of cancellation or postponement to the next class.
 

2)  CANCELLATION POLICY: Full refunds, less $75 administration fee, will be given provided a written (or FAX or e-mail) notice of cancellation is received at least 4 weeks prior to the class. Within the four weeks prior to a class no refunds will be issued; however, you are allowed to designate another person to attend up to 1 week prior to the course (for an adminstrative fee of $75).

3) LATE FEES: A late fee of $100 will be assessed if you register less than 4 weeks in advance; any such late registration is non-refundable, but can be exchanged for future classes or given to others.


 

64-slice Cardiac CT Courses - Coronary CT Angiography
                         Using the 64-slice CT scanner from Philips.

Dates in 2007-2008:

For 2-day Cardiac CT (64 slice) Courses –
64 slice Coronary CT Angiography

    Year 2007

            Program 1: February 23-24, 2007 - done
            Program 2:  March 16-17, 2007
            Program 3:  April 20-21, 2007
            Program 4:  May 4-5, 2007
            Program 5:  June 22-23, 2007
            Program 6:  July 27-28, 2007
               None in August 2007
            Program 8:  Sep 14-15, 2007 
            Program 9:   n/a
            Program 10:  Nov 16-17, 2007 - TBA
               None in Dec  2007

Year 2008
Jan 18-19, 2008
March 21-22, 2008
May 16-17, 2008

 

Suggested Hotel(s) in Cleveland, OH:
Spending a week-end in Cleveland, OH?
TOURISM Info can be downloaded here....click here

Hotel Information.. download here.
Directions to Metro.....here
Info on Cleveland....here

Airports: Cleveland, OH  can be reached by flying into Cleveland  Hopkins  International. Airport (http://www.clevelandairport.com/; Symbol: CLE).