Cohort 15 Basic Course Registration Form – Canadian Rheumatology Ultrasound Society

Student Information

Name*

First Last

Specialty (i.e rheum, family medicine etc)

Comfort with Ultrasound

Do you have a local MSK-US mentor? If yes, who?

Are you a pediatric provider? *Will do our best to group peds practitioners together.*

Email*

Phone*

Mailing Address*

Address Line 1 Address Line 2 City Province / State Postal Code / Zip Code Country

Meals are included. If you have any dietary restrictions or allergies, please specify:

How did you hear about our course?

On submitting this form you will be redirected to a secure payment page hosted by Stripe to complete the payment process.

Attendee Registration Type*

Total

$ 0.00 CAD