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  • Ohio Certified Radiation Expert Renewal

Get Ohio Certified Radiation Expert Renewal

Irst Mr. Last Ms. Dr. M.I. Home address City State Home telephone ( ) ZIP County Work telephone ( ) E-mail address II. Radiation Expert Certification Category (Indicate more than one if applicable) Therapeutic Diagnostic other than mammography Mammography III. Credentials Therapeutic Rule 3701:1-66-03(C) - Submit evidence of one of the following: Certification by the American Board of Radiology in therapeutic radiological physics, roentge.

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How to fill out the Ohio Certified Radiation Expert Renewal online

This guide provides a comprehensive overview for users looking to efficiently complete the Ohio Certified Radiation Expert Renewal form online. It outlines each section and field of the form, ensuring clarity and ease of understanding for all users.

Follow the steps to fill out your renewal form correctly

  1. Click ‘Get Form’ button to obtain the renewal form and access it in your preferred editing format.
  2. Begin by entering your personal information in Section I. Provide your Social Security number, birthdate, name, title, home address, city, state, home telephone number, ZIP code, county, work telephone number, and email address.
  3. Move to Section II where you will select your certification category. Indicate your applicable categories such as therapeutic, diagnostic other than mammography, or mammography by marking the corresponding options.
  4. In Section III, provide your credentials. Depending on your selected category, you will need to submit evidence of relevant certifications or degrees. Follow the specific guidelines outlined for each category to ensure all necessary documentation is submitted.
  5. Proceed to Section IV, the Statement of Declaration. Here, you must print your name and affirm the accuracy of the statements in your application. Ensure you read and understand the provided declarations regarding inspection rights and the non-refundable nature of fees.
  6. Finally, in Section V, prepare to submit your application fee. Include a check or money order for $100.00 for one certification category and $100.00 for each additional category, made out to 'TREASURER, STATE OF OHIO.' Address it for submission as indicated.
  7. After completing all sections, review your form for accuracy. You can save any changes, download a copy for your records, print it out, or share it as needed before final submission.

Complete your Ohio Certified Radiation Expert Renewal online today to ensure your certification remains current.

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