Get Harris Health Radiography Program

Filling out the Harris Health Radiography Program application form is an important step toward advancing your career in medical radiography. This guide will provide you with clear, step-by-step instructions on how to complete the application efficiently and accurately.

Follow the steps to successfully complete your application

1. Press the ‘Get Form’ button to access the application form and open it for editing.
2. In the first section, provide your name and Social Security Number (SSN). This information identifies you throughout the application process.
3. Enter your current address, including city, state, and zip code. Ensure that your contact information is accurate and up-to-date.
4. Next, provide your email address and both home and work telephone numbers. This ensures that the program can easily reach you for any follow-up or important communications.
5. In the emergency contact section, include the name, relationship, and telephone number of someone to be contacted in case of an emergency.
6. Indicate if you have applied to another medical radiography program this year or in the past, and provide the name of the referring individual, if applicable.
7. You will be asked about any criminal convictions or charges you may have faced. Providing truthful information is crucial, as it does not necessarily disqualify you from admission.
8. Indicate whether you have worked in a healthcare facility previously. If yes, briefly describe your experience.
9. Fill out the education and training section. List your high school, college, and any professional certifications or licenses you hold, including the institution's name, address, attendance dates, and major/minor where applicable.
10. Provide information regarding your health status by selecting from the options: excellent, good, fair, or poor.
11. If applicable, detail your military service, including branch of service, dates entered and discharged, rank at discharge, and type of discharge.
12. List your employment history in chronological order, starting with your most recent job. Include employer names, dates employed, job titles, responsibilities, and reasons for leaving.
13. In the designated space, explain your motivation for pursuing a career in medical radiography. You may attach an additional sheet if more space is required.
14. Read the applicant’s statement carefully. You must certify that the information provided is correct to the best of your knowledge. Then, sign, print your name, and include the date.
15. Once all sections are completed, review your application for accuracy. After verifying that all information is correct, you may save your changes, download, print, or share the completed application.

Complete your application online today to take the first step towards your future in medical radiography.