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Echo Cardiographer
Name:
Verify ID:
Date:
Click To Highlight:
1 - No Experience
2 - Minimal
3 - Moderate
4 - Very Experienced
A.
Echocardiographer
1
2
3
4
A.
Special Procedures
Bubble Study
Transesophogeal Echocardiogram
Contrast Study
Treadmill Stress Echo
Other
B.
Other Cardiology Testing
Holter Monitors
EKG
C.
Pediatric Echo
2-dimensional
M-mode
PW Doppler
CW Doppler
Color Doppler
D.
Neonatal Echo
2-dimensional
M-mode
PW Doppler
CW Doppler
Color Doppler
E.
Certifications
Yes
No
BLS
ACLS
Other
B.
Registrations
Yes
No
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RDCS #
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ROUB #
RDMS #
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