Get Au Asmirt Application For Angiography 2020

Filling out the AU ASMIRT Application For Angiography is a crucial step for individuals seeking certification in vascular interventional imaging. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to complete your application online.

1. Click 'Get Form' button to obtain the form and open it in the editor.
2. Complete your contact details by filling in your membership number, surname, maiden name, given names, title, date of birth, residential address, town/suburb, state, postcode, and telephone numbers (home, work, mobile) along with your email address.
3. In Part A, fill out the theoretical component by indicating the month and year you took the vascular level 1 examination.
4. In Part B, provide a statement of clinical experience in angiography. Write your name and certify that you have performed over 150 vascular angiography examinations within the specified 12-month period, ensuring this period falls within the last three years. Include your signature and the date.
5. Request your supervisor to verify your clinical experience. They should fill out their name, position, site name, and contact details and provide their signature and the date.
6. Complete the payment authority section by selecting the payment type and indicating the appropriate credit card details, including the card number, expiry date, CCV number, cardholder's name, and signature. Ensure you have also noted the total costs.
7. Review all entries for accuracy, make any necessary adjustments, and then save your changes. You may now download, print, or share the completed form via the available methods.
8. Submit the form via email by following the provided instructions, or alternatively, send it to the specified email address.

Begin filling out your application online today to take the next step in your certification journey.