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if you wish to Pay by CHECK
or CREDIT CARD
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(Ignore
this signature line if you are e-mailing us this form as a .pdf
file)
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NAME
as Printed on Your Credit Card
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We
only accept VISA, Mastercard and DISCOVER Card. We can not
accept American Express or other cards. Sorry.
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or
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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.
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.
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).