EACVI TEE CERTIFICATION: LIST OF 125* PROCEDURES FORM - escardio 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your candidate number, which can be found on your exam result and invitation letter. Remember to maintain confidentiality by not including your name.
3. In the designated section, list the 125 echocardiography studies you have performed. Ensure that this list is signed by your supervisor, who should also provide their name and surname.
4. Fill in the center, city, and country where you conducted these studies. This information is crucial for the Certification Assessment Committee.
5. Complete one of the provided tables based on your case mix. For each study, include the primary diagnosis and approximate numbers of cases as specified.
6. Chronologically order your studies from first to last, filling in details such as study date, patient’s hospital record number, study category, comments, and main diagnosis or conclusion where applicable.

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