Application for Diagnostic (DIAG) Master Instructor There are three requirements for DIAG Master Instructor (MI) status:1. Certification as DIAG IP.2. A point for each Question #6,7,8,9.3. A reference from a Master Instructor in Question #10.Applications are processed within 30 days.Asterisk denotes answer required. Question Title * 1. Please choose one of the following options for your DIAG MI application: I am applying for modular DIAG MI status. This is for modular DIAG TI members. I am applying for DIAG MI status. This is for DIAG TI members. Question Title * 2. Please enter date: Select the date below: Date Question Title * 3. Please enter your name: Question Title * 4. Please identify your profession: MD Nursing professional Paramedical Resident Physician Assistant Medical student Other (please specify) Question Title * 5. Please enter your IP Number: You must answer affirmative for each Question #6,7,8,9 in order to be certified as a DIAG MI and proceed to the next question. Question Title * 6. Please confirm that:(1 point) I have been a DIAG IP for at least one year Question Title * 7. Have you taught at least two CPoCUS/non-CPoCUS accredited DIAG courses or taught individuals? Please list names and dates of courses.(1 point) Yes No Please list two course names and dates or individuals Question Title * 8. Have you given the CPoCUS DIAG exams (Written, Visual, Practical) three or more times?(1 point) Yes, I have given the CPoCUS DIAG exams (Written, Visual, Practical) three or more times Question Title * 9. Have you provided 40 or more hours of DIAG IP training in the past year?(1 point) Yes, I have provided 40 or more hours of DIAG IP training in the past year Question Title * 10. Please provide a short reference from a DIAG Master Instructor. (1 point) I have provided an online reference by sending the following link to the Master Instructor:https://www.surveymonkey.com/r/MIMref I have provided a hardcopy of a reference letter in Question #11 Question Title * 11. Attach other material (if applicable). Please label file with your full name PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please label file with your full name Question Title * 12. Attach other material (if applicable). Please label file with your full name PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File Please label file with your full name Question Title * 13. Attestation: I pledge to uphold CPoCUS values including rigorous standards of POCUS training and non-distribution of certification exams prior to examination. Done