Cardiovascular Imaging Coalition (CVIC) Interest Form

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1. Please enter your name.

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2. Please provide your email address. The NBE, Inteleos, and the CVIC will use this to send updates as they become available.

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3. What imaging specialties do you use in your practice? Select all that apply. (Required.)

Cardiovascular Computed Tomography (CT)

Nuclear Cardiology (NC)

Cardiovascular Magnetic Resonance Imaging (CMR)

Echocardiography

None of the above

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4. Which board certifications do you currently hold? (Required.)

CBCCT Testamur

CBCCT Diplomate

CBNC Testamur

CBNC Diplomate

CBCMR Testamur

CBCMR Diplomate

NBE Testamur

NBE Diplomate

None of the above

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5. Would you like to be considered as a volunteer Subject Matter Expert for the CVIC in one or more areas?

Yes

No

Maybe