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Radiologic Health Branch (RHB)

Radiologic Technology and Nuclear Medicine Technology     

The information you provide to the RHB may be disclosable under the California Public Records Act (PRA).  In response to PRA requests, RHB may release the address of record for Radiologic Technologists, X-ray Technicians, Nuclear Medicine Technologists, Physician Assistants (PA) and Certified Supervisor and Operators. If you wish to provide RHB with an alternate address that will be released to the public release upon request, please submit form CDPH 8391 (PDF).

Applications and FAQS

RHB's application forms (below) are categorized as follows:

  • Radiologic Technologist (RT) - Initial Application Forms
  • Limited Permit X-ray Technician (XT) - Initial Application Forms
  • Licentiate Forms (i.e. MD, DO, DC, DPM) - Initial Application Forms
  • Nuclear Medicine Technologist (NMT) - Initial Application Form
  • Special Renewal Application Forms - RT, XT, NMT, PA & Licentiates
  • Miscellaneous Forms: Change of Name/Address - RT, XT, NMT, PA & Licentiates

IMPORTANT NOTE:  If you did not receive your renewal notice, use the "Special Renewal Application" as found below.

General Information or Links:

 Radiologic Technologists (RT) - Initial Application Forms

[Do Not Use For Renewal Purposes]

  • CDPH 8200 (PDF) - Radiologic Technology Certificate Application (Diagnostic & Therapeutic).
  • CDPH 8200 M (PDF) - Mammographic Radiologic Technology Certificate Application
  • CDPH 8218 (PDF) - Radiologic Technologist Fluoroscopy Permit Application - Examination Required 
  • CDPH 8228 (PDF) - Radiologic Technologist Fluoroscopy Permit Application - Examination Not Required 

  • CDPH 8241 (PDF) - PET/CT On-The-Job (OJT) Registration Application 

 Limited Permit X-ray Technicians (XT) - Initial Application Forms ā€‹ā€‹

[Do Not Use For Renewal Purposes]

 Licentiates (MD, DO, DC, DPM) - Initial Applications Forms

[Do Not Use For Renewal Purposes]

  • CDPH 8230 (PDF) - California Licentiate Supervisor & Operator Permits.  Use this form for the following permits:
    • Fluoroscopy Supervisor and Operator Permit
    • Radiography Supervisor and Operator Permit
    • Dermatology Supervisor and Operator Permit
  • CDPH 8231 (PDF) - California Radiology S&O Certificate. (For Radiologists & Radiation Oncologists ONLY)
  • CDPH 8711 (PDF) - California Licentiate X-ray Bone Densitometry S&O Permit
  • CDPH 9109 (PDF) - Temporary Fluoroscopy Permit Application for Supervisors and Operators.  (For licensed physicians & podiatrists only.) 

 Nuclear Medicine Technologists (NMT) - Initial Appication Form

[Do Not Use For Renewal Purposes]

  • ā€‹CDPH 8435 (PDF) - Nuclear Medicine Technology Certificate Application

 Special Renewal Application (SRA) Forms

Use Only if You Did Not Receive a Certificate/Permit Renewal Notice.

SRA Form for CRTs only:

CDPH 8200 SRA III (PDF)

SRA Form for XTs holding the DEXA Permit only:

SRA Form for XTs (Excluding DEXA) only:

CDPH 8232 SRA III (PDF)

SRA Form for Physician Assistant (PA) Fluoroscopy Permits:

CDPH 8217 SRA III (PDF)

SRA Form for Licentiate S&O Certificate or Permits:

CDPH 8238 SRA III (PDF)

SRA Form for Certified Technologist, Nuclear Medicine (CTNM) only:

CDPH 8435 SRA III (PDF)

 Reinstatement Fee Schedule - X-ray (PDF)

 Miscellaneous Forms

  • CDPH 8391 (PDF) - Change of Name or Address Form - RT, XT, NMT, PA & Licentiatesā€‹        
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