Pediatric POCUS Application Form

Please complete this application form for the Fundamentals of Pediatric Point-of-Care Ultrasound Certificate Program. Applications will be screened, and selected candidates will receive an offer letter.

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Click or drag a file to this area to upload.
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Click or drag a file to this area to upload.
Click or drag a file to this area to upload.
o I hereby affirm that the information on the registration form is true and accurate.
o I authorize the MBRU team to collect personal and academic information for the screening process.
o I certify that I have carefully reviewed the MBRU website's General Information, Admission Criteria, and Program Terms and Conditions.
o I confirm that I can engage in learning and assessment in English.
o I understand that I must have access to an ultrasound machine with image saving capability at my workplace.
o I understand that the ultrasound scans performed during Module 3 and Module 5 will be in my own clinical workplace and the videos uploaded in the e-Portfolio will not include any patient identifiers.
o I understand that the ultrasound scans I obtain during Module 3 and Module 5 are for educational purposes only and will not interfere with or replace the usual medical care.
o I understand that the issue of the POCUS certificate depends on my successful completion of all program requirements.
o I confirm that I can attend the face-to-face workshops at MBRU facilities, and I understand that I will cover all travel expenses if required.