EMG Solutions Request for Mentoring Form - The EMG Solutions Institute

Request for Mentoring Form

Personal Info

Name(Required)

First Last

Company

Email(Required)

Phone(Required)

Country Phone Number

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mentoring Options

Mentoring Choices

On-site Shadowing at EMG Solutions

At Your Clinic

On-site Shadowing at EMG Solutions(Required)

Pricing is Per Week

On-site clinical mentoring is provided using our patients in our clinics. Mentee will participate in and perform nerve conduction studies on real patients. Instruction in needle EMG will be demonstrated and technique reinforced. Mentee will receive training critical thinking, pathology, differential diagnosis, and EMG/NCS data interpretation.

At Your Clinic(Required)

Pricing is Per Day

Price:

Quantity(Required)

Please enter a number from 1 to 10.

Mentee will be responsible for scheduling patients, and providing a location. In addition to the $1500 per day, mentee will pay for mentor's transportation, housing, and meals.

Total

Credit Card