Radiologic Health Branch (RHB)

Radiologic Technology and Nuclear Medicine Technology Applications and FAQS

RHB's application forms 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; and Accomodation Request - 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.

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

CDPH 8200 - Radiologic Technology Certificate Application (Diagnostic & Therapeutic). [DO NOT USE FOR CERTIFICATE RENEWAL]
CDPH 8200 M - Mammographic Radiologic Technology Certificate Application [DO NOT USE FOR CERTIFICATE RENEWAL]
CDPH 8200 SRA [ONLY USE IF YOUR CERTIFICATE EXPIRES ON OR BEFORE 12/31/14] - Special Renewal Application form for CRTs only.
CDPH 8200 SRA II - Special Renewal Application form for CRTs only. (Only use if your certificate expires on or after January 31, 2015)
CDPH 8218 - Radiologic Technologist Fluoroscopy Permit Application [DO NOT USE FOR PERMIT RENEWAL]
Fluoroscopy Examination Notice
Radiography Radiation Protection Syllabus

CDPH 8232 - XT Application [DO NOT USE FOR PERMIT RENEWAL]
CDPH 8232 BD - XT Bone Densitometry Permit Application [DO NOT USE FOR PERMIT RENEWAL]
CDPH 8232 BD SRA [ONLY USE IF YOUR CERTIFICATE EXPIRES ON OR BEFORE 12/31/14] - Special Renewal Application - XT - Bone Densitometry.
CDPH 8232 BD SRA II - Special Renewal Application - XT - Bone Densitometry. (Only use this form if your certificate expires on or after January 31, 2015.)
CDPH 8232 SRA [ONLY USE IF YOUR CERTIFICATE EXPIRES ON OR BEFORE 12/31/14] - Special Renewal Application - XT (Excluding Bone Densitometry)
CDPH 8232 SRA II - Special Renewal Application - XT (Excluding Bone Densitometry). (Only use this form if your certificate expires on or after January 31, 2015.)
CDPH 9054 - XT Digital Authorization Application

CDPH 8217 SRA - Special Renewal Application form for Physician Assistant Fluoroscopy Permit
CDPH 8230 - California Licentiate Supervisor and Operator (S&O) Permits [DO NOT USE FOR PERMIT RENEWAL]
CDPH 8231 - California Radiology S&O Certificate. (For Radiologists ONLY) [DO NOT USE FOR CERTIFICATE RENEWAL]
CDPH 8238 SRA [ONLY USE IF YOUR CERTIFICATE EXPIRES ON OR BEFORE 12/31/14] - Special Renewal Application-- S&O Certificate or Permit.
CDPH 8238 SRA II - Special Renewal Application S&O Certificate or Permit. (Only use this form if your certificate/permit expires on or after January 31, 2015.)
CDPH 8711 - California Licentiate X-ray Bone Densitometry S&O Permit.
Fluoroscopy Examination Notice - Information Notice regarding fluoroscopy study material.
Radiography Radiation Protection Syllabus - Provides information on radiation protection in radiologic technology.

CDPH 8435 - Nuclear Medicine Technology Certificate Application [DO NOT USE FOR PERMIT RENEWAL]
CDPH-8435 SRA (PDF) [ONLY USE IF YOUR CERTIFICATE EXPIRES ON OR BEFORE 12/31/14] - Special Renewal Application form for Certified Technologist, Nuclear Medicine (CTNM) only.
CDPH 8435 SRA II - Special Renewal Application form for CTNM only. (Only Use if your certificate expires on or after January 31, 2015)

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