Apply to become a FUSIC® Trainer

You can sign up to become a Trainer for our FUSIC® Lung, Abdomen, Vascular, DVT or Haemodynamics modules at any time using the form below.

Become a FUSIC® Trainer

First name ^* (required)

Last name ^* (required)

Email ^* (required)

Job title/grade ^* (required)

What is your profession?

Hospital/Trust address

City/region ^* (required)

What module(s)are you applying to be a FUSIC® Trainer in? ^* (required)

Abdomen

DVT

Lung

Vascular Access

Other

Which of the following ultrasound qualifications have you held for at least the past 12 months? ^* (required)

If you answered 'other', please provide us with more information.

What date did you complete your qualification? ^* (required)

How many years have you been practicing ultrasound? ^* (required)

Please give a brief summary of your training and level of expertise in critical care ultrasound. ^* (required)

Please provide any supporting documentation if appropriate

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