Institution
Address
Town
Zip code
Head of institution
phone
E-Mail
Name:
Position:
Phone
MIBB-/accrediated:yesno
New member application together with the institute application:yesno
Please additional fill out the application form for individual MIBB-membership
Are there further physicians performing VAB at the applying institution? yesno
Email:
MIBB-accreddiated: yesno
MIBB-accreddiated:yesno
Please fill out a separate application form of MIBB-membership for any individual physician not yet accredeted
Stereotactic / DBT table:
availableused for VAB
Stereotactic / DBT upright:
Sonographic VAB system:
MRI coil and biopsy device:
Diagnostic imaging:
availableexternal cooperation
Pathology (that operates according to the guidelines of the Swiss Society of Pathology):
Gynecology / Oncology:
By applying for MIBB membership you agree to make the following commitments:
According to the consensus paper (5th April 2018) the following number of cases is required to maintain the accreditation after an initial training phase: 20 VAB interventions in the institute
a total of 20 VABs at the institution annuallya total of 12 VABs for any individual physician / annually
I agree to adhere to the quality assurance measures by entering all VAB interventions in the MIBB-data collection system (www.adjumed.net/mibb/)
Payment of the registration fee of 2.500.-CHF** Bank Account: Swiss Society of Senology, Bündtenweg 33, CH 4102 Binningen, IBAN CH29 0070 0110 0019 6133 2**Please attach proof of transfer
Only Pdf-Files, Word-Files or Images (png/jpeg); Max. Size 5mb
Please enter the correct Answer: 3x3=
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