Radiologic Health Branch (RHB)

Radiologic Technology and Nuclear Medicine Technology Applications and FAQS

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

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

Important: You are required to inform RHB of any change of name or mailing address within 30 calendar days of the change. Use form CDPH 8391 (PDF).

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

General Information or Links:

Radiologic Technologists (RT) Forms

CDPH 8200 (PDF) - Radiologic Technology Certificate Application (Diagnostic & Therapeutic). [DO NOT USE FOR CERTIFICATE RENEWAL]
CDPH 8200 M (PDF) - Mammographic Radiologic Technology Certificate Application [DO NOT USE FOR CERTIFICATE RENEWAL]
Special Renewal Application forms for CRTs only:

CDPH 8200 SRA (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES BEFORE 1/01/15.
CDPH 8200 SRA II (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES FROM 1/01/15 to 8/31/17.
CDPH 8200 SRA III (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES AFTER 8/31/17.

CDPH 8218 (PDF) - Radiologic Technologist Fluoroscopy Permit Application [DO NOT USE FOR PERMIT RENEWAL]
Fluoroscopy Examination Notice (PDF)

Limited Permit X-ray Technician (XT) Forms

CDPH 8232 (PDF) - XT Application [DO NOT USE FOR PERMIT RENEWAL]
CDPH 8232 BD (PDF) - XT Bone Densitometry Permit Application [DO NOT USE FOR PERMIT RENEWAL]
Special Renewal Application forms - XT - Bone Densitometry only.
- CDPH 8232 BD SRA (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES BEFORE 1/01/15.
- CDPH 8232 BD SRA II (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES FROM 1/01/15 to 8/31/17.
- CDPH 8232 BD SRA III (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES AFTER 8/31/17.
Special Renewal Application - XT (Excluding Bone Densitometry)

CDPH 8232 SRA (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES BEFORE 1/01/15.
CDPH 8232 SRA II (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES FROM 1/01/15 to 8/31/17.
CDPH 8232 SRA III (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES AFTER 8/31/17.

CDPH 9054 (PDF) - XT Digital Authorization Application

Licentiate Forms (MD, DO, DC, DPM, PA)

Special Renewal Application forms for Physician Assistant Fluoroscopy Permits:

CDPH 8217 SRA II (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES FROM 1/01/15 to 8/31/17.
CDPH 8217 SRA III (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES AFTER 8/31/17.

CDPH 8230 (PDF) - California Licentiate Supervisor & Operator Permits [DO NOT USE FOR PERMIT RENEWAL]
CDPH 8231 (PDF) - California Radiology S&O Certificate. (For Radiologists ONLY) [DO NOT USE FOR CERTIFICATE RENEWAL]
Special Renewal Application forms -- S&O Certificate or Permit.

CDPH 8238 SRA (PDF)- ONLY USE IF YOUR CERTIFICATE EXPIRES BEFORE 1/01/15.
CDPH 8238 SRA II (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES FROM 1/01/15 to 8/31/17.
CDPH 8238 SRA III (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES AFTER 8/31/17.

CDPH 8711 (PDF) - California Licentiate X-ray Bone Densitometry S&O Permit.
Fluoroscopy Examination Notice (PDF) - Information Notice regarding fluoroscopy study material.
Radiography Radiation Protection Syllabus (PDF) - Provides information on radiation protection in radiologic technology. If you are having difficulty accessing this document, please contact Marilyn.Cantrell@cdph.ca.gov to request this information in an alternate format.

Because of the examination change beginning July 1, 2018, the Radiography Syllabus will be retired on June 30, 2018, and should not be used as study material for the new examination. Please read this Notice .

Nuclear Medicine Technologists (NMT) Forms

CDPH 8435 (PDF) - Nuclear Medicine Technology Certificate Application [DO NOT USE FOR PERMIT RENEWAL]
Special Renewal Application forms for Certified Technologist, Nuclear Medicine (CTNM) only:

CDPH 8435 SRA (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES BEFORE 1/01/15.
CDPH 8435 SRA II (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES FROM 1/01/15 to 8/31/17.
CDPH 8435 SRA III (PDF) - ONLY USE IF YOUR CERTIFICATE EXPIRES AFTER 8/31/17.

Miscellaneous Forms

CDPH 8391 (PDF) - Change of Name or Address Form - RT, XT, NMT, & Licentiates

Page Last Updated :

appsfaqs

Radiologic Health Branch (RHB)

Radiologic Technology and Nuclear Medicine Technology Applications and FAQS

General Information or Links:

New California Radiography Supervisor & Operator Permit Examination Launches July 1, 2018.

Certification FAQs (PDF)

Continuing Education Credit Information (PDF)

CT-PET Information - Contact rhbschools@cdph.ca.gov.

X-ray & NMT Certification & Permitting Main Page

Radiologic Technologists (RT) Forms

Limited Permit X-ray Technician (XT) Forms

Licentiate Forms (MD, DO, DC, DPM, PA)

Nuclear Medicine Technologists (NMT) Forms

Miscellaneous Forms

Diseases and Conditions

Health and Safety

Licensing, Certification and Other Credentials

Family Health

Personal Health and Prevention

Health Facilities

Administrative

Briefings

Person Interested In

Radiologic Health Branch (RHB)

Radiologic Technology and Nuclear Medicine Technology Applications and FAQS

General Information or Links:

CT-PET Information - Contact rhbschools@cdph.ca.gov.

Radiologic Technologists (RT) Forms

Limited Permit X-ray Technician (XT) Forms ​​

Licentiate Forms (MD, DO, DC, DPM, PA)

Nuclear Medicine Technologists (NMT) Forms

Miscellaneous Forms

Limited Permit X-ray Technician (XT) Forms