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APS Membership Application & Guidelines

Advanced Practice Sonographer (APS) Membership Application & Guidelines

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APS Membership Application & Guidelines

Introduction

The Advanced Practice Sonographer (APS) membership category was designed by the SDMS to serve as a model for recognition of clinical excellence through appropriate standards of initial and continuing education, specialty certification, clinical experience, and professional publication. These guidelines were designed by SDMS to assist you in preparing application for APS membership. The purpose of the application process is to ensure that the applicant has met the standards established by the SDMS for APS membership. The SDMS appreciates your interest in becoming an APS member. If you have any questions or need further assistance after reviewing the Guidelines, please contact the SDMS Membership Marketing & Service Department. Common questions and answers can be found in the APS Frequently Asked Questions (FAQs), beginning on page 4. This publication is available on the SDMS website at http://www.sdms.org/membership/, and may be downloaded for your use.

Table of Contents

Page

Eligibility Information.................................................... 3 Application Process ..................................................... 3 APS Audit System ....................................................... 4 APS Appeal Process ................................................... 4 Frequently Asked Questions (FAQs) ........................4-5 Application APS Membership Application (page 1) ........................ 6 APS Membership Application (page 2) ........................ 7 Processing Fee............................................................ 8 Membership Dues (Initial and Renewal)...................... 8 Membership Renewal Annual Renewal Process ............................................ 9 Adding APS Specialties ............................................... 9 Appendix A - Forms APS Documentation Letter Template (APS-DL1) ...... 11 APS Renewal Documentation Letter Template (APS-DL2) ......................................... 12 APS CME Log Template (APS-CME) ........................ 13 Employment Documentation (APS-ED1)................... 14

Society of Diagnostic Medical Sonography Membership Marketing & Services Department 2745 Dallas Pkwy Ste 350 Plano, TX 75093-8730 Phone: 214-473-8057 Fax: 214-473-8563 Email: [email protected]

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APS Membership Application & Guidelines

Eligibility Information

Determine if your are eligible for this membership category. If you answer "yes" to each of the following questions, you are eligible to apply for SDMS APS Membership. 1. Have you been registered with the ARDMS or CCI for at least five (5) years in each specialty area in which you want to obtain APS membership? 2. Do you work a minimum of 24 hours per week clinically or in the supervision of clinical work and 800 scans in each specialty area in which you want to obtain APS membership? 3. Do you have a bachelor's degree in Diagnostic Medical Sonography, Cardiovascular Technology, or Echocardiography from an accredited university/ college? 4. Have you acquired 15 hours of CME credit in the past three (3) years in each specialty area in which you want to obtain APS membership? 5. Have you been published or accepted for publication in a peer-reviewed journal as author or co-author? If you answered "yes" to all of the preceding questions, please proceed to the next section.

Step 3

Request and submit an official transcript from the university/college at which your bachelor's degree was bestowed. Contact the Registrar's Office and request an "official" transcript. This transcript must be clearly marked as an "official transcript" and must be submitted with all requested documentation for APS membership.

Step 4

Submit copies of CME certificates and a completed APS CME Log (form APS-CME) for verification. Prior to submitting CME certificates to the SDMS, please document 15 hours of CME credit in each specialty area in which you want to obtain APS membership on the APS CME Log (form APS-CME). If you have courses that contain credits from multiple areas (ie. annual meetings) or courses with vague titles (ie. "Grand Rounds"), list only the amount of CMEs from each course which you are using to complete this requirement. NOTE: CMEs granted in the Other [OT] category are not accepted for any specialty area. All CME credits must have been obtained within the immediate past three (3) years AND must be ARDMS or CCI acceptable as appropriate. The APS CME Log MUST be accompanied by copies of your CME certificates. (You may submit multiple copies of the APS CME Log if you need additional space when listing CME courses.)

Application Process

Step 1

Complete the entire APS Membership Application included in this publication, beginning on page 6. Please provide all requested information and documentation. Incomplete or illegible applications will not be processed and will be returned to the applicant for completion.

Step 5

Submit a copy of your published (or accepted) peerreviewed journal article. This article must be ultrasound related. List the journal name, article title, publication or acceptance date, and citation (page number and publication volume) on the APS Membership Application. If the article has been accepted, but not yet published, please provide a copy of the journal editor's publication acceptance letter with a copy of the article.

Step 2

Obtain a notarized letter (form APS-DL1) from your employer documenting your job title, years of clinical employment, and clinical work experience*. An "APS Documentation Letter " template is included in this publication and must be used when providing this information. The letter must be printed on institutional letterhead and be notarized. Previous employment may not be verified by your current employer. Letters submitted not using the "APS Documentation Letter" template will be returned to the applicant along with all other submitted APS documentation.

*Clinical work experience is defined as performing sonography or direct supervision of diagnostic medical sonographers, students, or others performing sonographic examinations.

Step 6

Submit your completed application and all required documentation to the SDMS Membership Marketing & Services Department. Pay only application fees at this time. If paying by check or money order, please make payable to SDMS. Do not submit payment for dues at this time.

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APS Membership Application & Guidelines

APS Audit System

This system is designed to monitor compliance with APS standards set by the SDMS Board of Directors. An annual random audit of APS member information will consist of verification of APS specialty-specific clinical work experience and/or continuing education.

Question: What are the bottom-line rules for meeting the APS publication requirement? Answer: The article must be an ultrasound related research article, case study, or case report published in a peer-reviewed journal (e.g., JDMS). Abstracts, books, posters, oral presentations, book chapters and the JDMS Diagnostic Challenge do NOT meet the requirement. If you are unsure if your article will comply with APS requirements, please contact the SDMS Membership Marketing & Services Department at 800-229-9506, or by email at [email protected] Question: I'm not the primary author on my published article, do I meet the publication requirement? Answer: Yes, you may be listed in any place as a co-author. Question: Is there a registry test for the APS? Answer: APS is a SDMS membership category only. There is currently no registry test for APS. Question: Is the APS membership category designed for multi-specialty recognition? Answer: The APS membership category was primarily designed to recognize clinical expertise in a given area of sonographic clinical work. While it is theoretically possible to qualify for more than one specialty area APS recognition, the requirements of 24 hours per week and 800 scans per year will be applied to each specialty area. Question: Who can verify my clinical work experience on the APS Documentation Letter? Answer: This information should be verified by your direct supervisor, supervising physician or personnel/human resources director. Question: Can I have my current employer verify employment information from another institution or past employer? Answer: No, your current employer may verify only the experience you have at your current place of employment. Past employment or employment at another institution must be verified by personnel at those institutions.

Appeal Process

If an APS member is determined to be out of compliance with APS membership requirements, whether that noncompliance relates to the clinical work experience or the continuing education component, the member will be sent written notification. The notification will include the basis for the determination and information regarding the appeal process and documentation needed to support an appeal and reevaluation. If the member disagrees with the audit findings, the member may submit a letter of appeal to the SDMS Membership Marketing & Services Department. The letter should state the reasons for the appeal and include any documentation to support the appeal. If the member does not appeal within 30 days of notification, the audit findings will be considered final. Upon receipt of the appeal and any supporting documentation, the SDMS Executive Director will reevaluate the member's APS file. The Executive Director will notify the member within 60 days of receipt of the appeal of the final determination.

APS FAQs

Question: Is "APS" a certification or professional designation and can it be used as a part of my signature? Answer: No, APS is a SDMS membership category only and as such shall not be used in conjunction with your signature. Question: Does SDMS require that all APS membership requirements are met before the application will be accepted? Answer: Yes.

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APS Membership Application & Guidelines

APS FAQs (continued)

Question: What do I do if a past employer has gone out of business and I need to document my clinical experience at that facility? Answer: Submit a properly executed Employment Documentation Form (APS - ED1). That form can be found on page 14 of this publication. Question: What steps will I have to take to renew my APS membership? Answer: Please see the "Annual Renewal Process" section on page 9. Question: What happens if I cannot meet the APS renewal requirements? Answer: Your membership category will be changed to Active (ACT). Question: Why are APS dues higher than the other individual SDMS membership categories? Answer: The membership fee schedule is reviewed annually by the SDMS Board of Directors and the APS dues have been set to reflect the additional processing and verification time needed to insure the APS standards. This process requires individual handling and the process cannot be automated. Question: What is the normal turnaround time for processing an APS membership application? Answer: Normal processing time is 3-4 weeks, but this may vary in peak membership periods. Question: What do I do if I have CMEs listed in the `Other' category that actually belong to a specific specialty? e.g., AB, AE... Answer: All CMEs used to meet APS requirements must be specialty specific. You should contact the CME provider to petition category changes.

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APS Membership Application & Guidelines

Advanced Practice Sonographer (APS) Membership Application

Please Print or Type

Name: Mr./Ms./Dr. _________________________ __________________ ___ Credentials:_________________

Last First MI

Address 1:__________________________________________________________________________________ Address 2:__________________________________________________________________________________ City: _______________________________State/Province: _____________ Zip+4/Postal Code: ______________ Country: ____________________________ Daytime Phone: (_____)_____________________ Ext: __________ Email Address: ______________________________________________________________________________ Current SDMS membership number: Female Male

Please provide this information for verification and CME tracking purposes:

Birth Date:

/

/

Social Security Number:

XXX - XX -

Please check the specialty area(s) for which you are applying for APS membership:

Abdomen Breast

Cardiac (Adult) Cardiac (Fetal)

Cardiac (Pediatric) Neurosonology

Ob/Gyn Vascular

Registry Numbers (all applicable): ARDMS _____________ CCI _______________ ARRT ______________ Please check all specialty areas in which you are currently practicing:

Abdomen Breast RDMS RVS RT(CV) MD

Cardiac (Adult) Cardiac (Fetal) RDCS RCS RT(M) DO

Cardiac (Ped.) Musculoskeletal

Neurosonology Ob/Gyn RMSK RT(BS)

Vascular Veterinary NOTE: This application valid through 12/31/1

Registrations/Certificates you hold (please check all that apply):

RVT RCCS RT(S) RN

RPVI RPhS RT(VS)

Please check all specialty areas in which you are registered or certified:

Abdomen Breast

Cardiac (Adult) Cardiac (Fetal)

Cardiac (Ped.) Neurosonology

Ob/Gyn Vascular

Highest educational level completed:

Bachelor's Degree

Master's Degree

Doctorate Degree

SDMS Office Use Only: Member Number: ____________ Batch and/or Reference Number: ____________ Payment Type: ___________ Item #: ____________ Amount: ___________ Date Received:_________________

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APS Membership Application & Guidelines

EDUCATION - List Bachelor's Degree or higher only

Degree Institution (Name & Address) Date Degree Received

ARDMS REGISTRATION - List specialty area(s) for which you are apply for APS membership

Specialty Date Registered If applicable, describe reasons for any lapse in registration.

CLINICAL WORK EXPERIENCE - Attach extra page, if needed.

Dates Job Title Employer (Name, address, and Supervisor's Name) Typical/Average Scans Per Day

PUBLISHED ARTICLE(S)

Journal Name Article Title Publication Date/Publication Acceptance Date Citation

AFFIDAVIT

I, __________________________________, swear or affirm that the statements contained in this application and all supporting documentation are to the best of my knowledge true and accurate. I further affirm that I understand that falsification of information is a violation of the Code of Ethics for the Profession of Diagnostic Medical Sonography and will result in rejection of my APS Membership Application. I authorize SDMS to verify the submitted membership information by contacting employers (present and past), educational institutions, and my certification organization(s) at any time. I understand that in order to maintain eligibility for the APS membership category, I must maintain "active" status with my certification organization(s), and I will provide SDMS with documentation to verify my continued compliance with APS membership category requirements each year at membership renewal. I also understand that the one-time processing fee is non-refundable and any dues assessed for APS Membership upon application approval are non-refundable and can not be transferred. __________________________________________________ ___________________________________________

(Applicant Signature) (Date)

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APS Membership Application & Guidelines

APS Membership Processing Fee

There is a one time, non-refundable processing fee for each specialty area. Please use the following chart to calculate the appropriate fee to submit with your APS Membership Application. Write the specialty area(s) in which you are applying for APS membership in the column on the left. The column on the right indicates the processing fee for each specialty area. The "Total" is the sum of fees for each specialty area for which you are applying. The "Total" is the amount you should submit with your APS application and other required documentation. APS Specialty Area 1. 2. Application Fee $20 USD

+ $20 USD

Total $ ______ USD

Payment Method

Please indicate payment method (US dollars drawn on US bank): Check #____________ Charge: $20 $40 to: MasterCard Visa Money Order

American Express

Discover

Credit Card Number _______________________________________________ Expiration Date ____________ Cardholder's Name________________________________Signature _________________________________

(as it appears on card)

Cardholder's Billing Address __________________________________________________________________

(as it appears on statement) (Please include address, city, state/province/country, and zip+4/postal code)

APS Membership Dues

Initial Payment

Once your APS membership has been approved, your initial dues payment will be calculated based on the following criteria: 1) your current SDMS expiration date, and 2) your APS membership date of approval. Do not send a dues payment with your APS membership application. You will be billed for the appropriate dues once your membership has been approved.

Annual APS Renewal

Each year, prior to your annual anniversary date, you will be billed for annual APS dues. The APS dues are: $197 USD

Membership dues to the SDMS are not deductible as a charitable contribution for U.S. Federal tax purposes, but may be partially deductible as a business expense. The SDMS estimates 11.7% of your dues are not deductible because of the SDMS' lobbying activities on behalf of its members.

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APS Membership Application & Guidelines

Annual Renewal Process

Each year, prior to your annual membership anniversary date, you will be billed for the appropriate APS membership dues. At that time you will also be asked to submit documentation illustrating your continued compliance with APS membership category requirements in clinical experience and continuing education. This documentation consists of: 1. a properly executed APS Renewal Documentation Letter (Form APS-DL2), and 2. copies of CME certificates outlining (required) CMEs in your specialty area(s) if records indicate a deficiency, and 3. a completed copy of the APS CME Log (Form APS-CME) if a deficiency is noted. (You may submit multiple copies of the APS CME Log if you need additional space when listing CME courses.) The required documentation should be sent to the SDMS along with your dues payment and invoice. Membership dues may be submitted independant of documentation to ensure no membership lapse. Failure to submit this documentation will result in the loss of membership in the APS membership category. Membership will be converted to Active, and you will be sent notification of this category change. PLEASE NOTE: Do not submit renewal information prior to receiving your renewal packet by mail. Detailed instructions regarding the renewal process will be mailed to you including any changes to the process for that membership year.

Adding APS Specialties to your Current APS Membership

You may add specialty areas to your current APS membership each year during your annual membership renewal period. In order to achieve this you must return the following documentation with your membership renewal invoice: 1. a letter indicating your intent to add a specialty and the date of certification for that specialty, 2. the appropriate processing fee ($20 per specialty added), 3. additional copies of CME certificates and completed copy of the APS CME Log (form APS-CME) indicating compliance with the CME requirement for that specialty area, and 4. a properly executed APS Documentation Letter (Form APS - DL1) for the added specialty. Please note: If you add a specialty to your APS membership, you will be required to submit a Form APS - DL1 for the new specialty area and a Form APS - DL2 for the renewing specialty. Note: Specialty areas may not be added to your current APS membership unless you have a Bachelor's Degree in Diagnostic Medical Sonography, Cardiovascular Technology, or Echocardiography.

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APS Membership Application & Guidelines

APPENDIX

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APS Membership Application & Guidelines

APS Documentation Letter Template - APS-DL1

A properly executed copy of this letter must accompany your APS Membership Application and documentation. This letter must be printed on institutional letterhead and the Personnel Director's (or Supervisor or Supervising Physician) signature must be notarized.

(Institutional letterhead)

APS Documentation Letter

(Date) Membership Marketing & Services Coordinator Society of Diagnostic Medical Sonography 2745 Dallas Pkwy Ste 350 Plano, TX 75093-8730 Dear SDMS Membership Coordinator, This letter is to document that ___________________________________________ has the job title and job

(sonographer's name and ARDMS/CCI registry number)

description of _______________________________________.

(current job title)

I affirm that ______________________________ has satisfactorily performed his or her duties in the area(s) of

(sonographer's name)

____________________________________________________, maintaining a minimum of 24 hours per week of

(List all specialty areas for which APS membership is being sought.)*

clinical work per specialty, from _________________________ to _______________________.

(start date) (current or end date)

I further affirm that ___________________________________ has satisfactorily performed or supervised at least 800

(sonographer's name)

sonographic examinations per year per APS specialty during this time. I, __________________________________________________, affirm that the above statements are true based on

(Personnel Director's (or Supervising Physician in a private clinic) name

past employment and work experience only at the institution listed on this letterhead. __________________________________________________________

Personnel Director's (or Supervisor or Supervising Physician) Signature and Title

__________________________________________________________

Notary Seal, Signature, and Date

* Abdomen, Adult Cardiac, Breast, Fetal Cardiac, Neurosonology, Ob/Gyn, Pediatric Cardiac, Vascular.

APS-DL1

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APS Membership Application & Guidelines

APS Renewal Documentation Letter Template - Form APS-DL2

A properly executed copy of this letter must accompany your SDMS APS membership renewal. This letter must be printed on institutional letterhead, signed by your Personnel Director's (or Supervisor or Supervising Physician) and by you. Your signature must be notarized.

(Institutional letterhead)

APS Documentation Letter

(Date) Membership Marketing & Services Coordinator Society of Diagnostic Medical Sonography 2745 Dallas Pkwy Ste 350 Plano, TX 75093-8730 Dear SDMS Membership Coordinator, This letter is to document that ___________________________________________ has the job title and job

(sonographer's name and ARDMS/CCI registry number)

description of _____________________________________.

(current job title)

I affirm that ______________________________ has satisfactorily performed his or her duties in the area(s) of

(sonographer's name)

____________________________________________________, maintaining a minimum of 24 hours per week of

(List all specialty areas for which APS membership is being sought.)*

clinical work per specialty, from _________________________ to _______________________.

(start date) (current or end date)

I further affirm that ___________________________________ has satisfactorily performed or supervised at least 800

(sonographer's name)

sonographic examinations per year per APS specialty during this time. I, __________________________________________________, affirm that the above statements are true based on

(Personnel Director's (or Supervising Physician in a private clinic) name

past employment and work experience only at the institution listed on this letterhead. __________________________________________________________

Personnel Director's (or Supervisor or Supervising Physician) Signature and Title

I, the undersigned, swear or affirm that the statements contained in this document are to the best of my knowledge true and accurate. I further affirm that I understand that falsification of information is a violation of the SDMS Code of Ethics and will result in rejection of my APS membership renewal. __________________________________________________________

SDMS APS Member's Signature, and Date

__________________________________________________________

Notary Seal, Signature, and Date APS-DL2

* Abdomen, Adult Cardiac, Breast, Fetal Cardiac, Neurosonology, Ob/Gyn, Pediatric Cardiac, Vascular.

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APS Membership Application & Guidelines

APS CME Log Template - Form APS-CME

Please use the following chart to outline your CME credits required for APS membership. NOTE: Documentation of (15) CME credits is required for each APS specialty area. For New Membership: See step 4 of the Application Process for use of this form. For Membership Renewal (if deficient): ONLY credits earned 3 years prior to your current APS Membership expiration are valid for use during the renewal period. This form MUST be accompanied by copies of CME certificates acceptable by your certification organization; which fulfill the APS CME requirement. Name: _______________________________ Specialty 1: _________ Specialty 2: _________ Specialty 3: _________

Date

01/01/2000 (Sample)

Specialty*

OB (Sample)

Title of Course

1st Annual Preconvention & Convention for Ultrasound (Sample)

Credit Hours in Specialty

2.5 (Sample)

* AB=Abdomen (includes Small Parts) AE = Adult Cardiac BR = Breast FE = Fetal Cardiac NE = Neurosonology OB = Obstetrics/Gynecology VT = Vascular Technology

PE = Pediatric Cardiac

I, the undersigned, swear or affirm that the statements contained in this document are to the best of my knowledge true and accurate. I further affirm that falsification of information is a violation of the SDMS Code of Ethics and will result in rejection of my APS Membership Renewal. _________________________________________________________

SDMS APS Member's Signature

04/13

Total CMEs for specialty 1: __________ Total CMEs for specialty 2: __________ Total CMEs for specialty 3: __________

Date

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APS Membership Application & Guidelines

Employment Documentation

This form may be used in lieu of the required APS Documentation Letter only if your employment records with a previous employer are completely inaccessible or destroyed. This information will be verified.

1. APS Applicant's Name: _________________________________________________________________________ 2. Maiden Name (if applicable):_______________________________ SDMS Member # (if applicable) ____________________ 3. Address:_____________________________________________________________________________________

Street City State/Province Zip+4/Postal Code Country

4. Name and last known address of company: _________________________________________________________ _______________________________________________________________________________________________ 5. Reason for inability to obtain employment records:

Company out of business (date ____________________) Other (Please specify________________________________________________________________________)

6. Dates of employment at this company: From _____ / _____ / ________ to _____ / _____ / ________ 7. Job Title during your employment: ________________________________________________________________ 8. Immediate Supervisor during this time period: _______________________________________________________

(Print First and Last Name and Title)

9. How many hours per week did you perform ultrasound examinations? ___________________________________ 10. In which specialty area(s) are you applying for APS membership?

Abdomen Breast Cardiac (Adult) Cardiac (Fetal) Cardiac (Pediatric) Neurosonology

Ob/Gyn Vascular

11. How many hours per week did you perform ultrasound examinations in your first APS specialty?_________ How many scans did you perform in this specialty per year? _____________ 12. If applicable, how many hours per week did you perform ultrasound examinations in your second APS specialty? ____________ How many scans did you perform in this specialty per year? _____________ 13. If applicable, how many hours per week did you perform ultrasound examinations in your third APS specialty? ____________ How many scans did you perform in this specialty per year? _____________ I, the undersigned, swear or affirm that the statements contained in this document are to the best of my knowledge true and accurate. I further affirm that I understand that falsification of information is a violation of the SDMS Code of Ethics and will result in rejection of my APS Membership Application.

__________________________________________________ __________________________________

Applicant's Signature Date

__________________________________________________________

Notary Seal, Signature, and Date

APS-ED1

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