SDMS #: CCI #: ARDMS #: CARDUP #: ARRT #: BIRTHDATE: DATE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 / 120 = TOTAL MINUTES: TOTAL CREDITS INSTRUCTOR SIGNATURE STUDENT SIGNATURE TIME SPENT INSTRUCTING (IN MINUTES) EMAIL ADDRESS: INSTRUCTOR NAME: SDMS Continuing Medical Education Clinical Instructor Log Society of Diagnostic Medical Sonography 2745 N Dallas Pkwy, Ste 350, Plano, TX 75093 Phone: 214-473-8057, ext. 112 http://www.sdms.org SDMS APPROVAL NUMBER: CAAHEP-ACCREDITED PROVIDER: CATEGORIES: AB = Abdominal Sonography, AE = Adult Echocardiography, BR = Breast Sonography, FE = Fetal Echocardiography, MSK = Musculoskeletal, NE = Neurosonography, OB = Obstetric and Gynecologic Sonography, PE = Pediatric Echocardiography, PS = Pediatric Sonography, SPI = Sonography Principles and Instrumentation, VT = Vascular Technology, OT = Other. Please note that clinical instructorship credit is calculated as follows: 2 hours instruction = 1 CME credit. Credits awarded may not exceed 6.0 in a calendar year.
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SDMS #: CCI #:
ARDMS #: CARDUP #:
ARRT #: BIRTHDATE:
DATE
1
2
3
4
5
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7
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9
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12
13
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/ 120 = TOTAL MINUTES: TOTAL CREDITS
INSTRUCTOR SIGNATURE STUDENT SIGNATURETIME SPENT INSTRUCTING (IN MINUTES)
EMAIL ADDRESS:
INSTRUCTOR NAME:
SDMS Continuing Medical Education Clinical Instructor LogSociety of Diagnostic Medical Sonography
2745 N Dallas Pkwy, Ste 350, Plano, TX 75093 Phone: 214-473-8057, ext. 112 http://www.sdms.org
SDMS APPROVAL NUMBER:CAAHEP-ACCREDITED PROVIDER:
CATEGORIES: AB = Abdominal Sonography, AE = Adult Echocardiography, BR = Breast Sonography, FE = Fetal Echocardiography, MSK = Musculoskeletal,NE = Neurosonography, OB = Obstetric and Gynecologic Sonography, PE = Pediatric Echocardiography, PS = Pediatric Sonography, SPI = Sonography Principles and Instrumentation, VT = Vascular Technology, OT = Other. Please note that clinical instructorship credit is calculated as follows: 2 hours instruction = 1 CME credit. Credits awarded may not exceed 6.0 in a calendar year.
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