Registration - PoCUS East

First Name *

Last Name *

Email *

Phone *

Address *

Address

Street Address

Suite or Unit

City

Province

Postal

For residents of Canada only.

Please select the description that best describes you: *

Please select the description that best describes you:

Have you taken an introductory ultrasound course? *

Did your introductory course above include lung scanning (for pneumothorax and pleural effusion)? *

Yes

No

Do you plan to stay at the course hotel? *

Yes

No

Where did you hear about this course? *

Comments or questions?

Which course date? *

Total $ (+HST)

Credit Card

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