MRI Fellowship Registration

Please fill this form and complete payment at least two weeks prior to arriving for a fellowship so that we may tailor course content to your needs. You can use the Paypal button directly above or below this form to complete your payment.

Email address *

What is the scheduled start-date of your fellowship? *

Please note that you need to first speak with Dr. Sage to agree on a mutually acceptable date.

YYYY

What is your name? *

Your answer

What is the name of your clinic or university? *

Your answer

What are your credentials? *

DVM

PhD

DACVR

Other

Required

What best describes your veterinary practice? *

Radiologist

Radiology resident currently in training

Post-residency trainee

Specialist

GP with an interest in MRI

What best describes your daily interaction with MRI studies? *

My practice owns an MRI machine

I refer my MRI cases to a human or remote veterinary imaging center for scans

I read teleradiology MRI cases for outside practices

I'm just looking for more MRI clinical experience, without direct access to MRI cases

Below is a list of topics that we generally cover. Please check any that you have a specific interest in or need to improve on. *

Physics of MRI, basic imaging sequences, protocol development, and patient positioning for optimal imaging quality

Brain: including neoplastic, inflammatory/infectious, vascular, congenital and neurodegenerative conditions

Spine: including intervertebral disc disease, neoplastic, inflammatory/infectious, vascular, and structural abnormalities

Orthopedic: including shoulder, elbow, stifle, and tarsus/carpus

Nerve sheath tumors (in their many locations)

Abdominal: including liver, spleen, portosystemic shunts, adrenal, pancreas, and genitourinary conditions

Thorax: including mediastinum, heart, pulmonary, and thoracic wall conditions

Head: including nasal, middle and inner ear, oral cavity, ocular and retrobulbar, salivary, and lymphatic conditions

Required

What specific goals do you want to achieve at the completion of this course? *

Your answer

Do you have any particular areas of interest that we should plan to cover? *

Your answer

Is there any other information we can provide for you about Georgetown, activities, hotels, restaurants, airport transportation, weather, etc? *

Your answer

I agree to use the Paypal button below to complete payment for this fellowship at least two weeks prior to my arrival. *

Yes

Required

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