Get Flm Form

Filling out the Flm Form online can be a straightforward process when guided correctly. This guide provides a clear, step-by-step approach to help you navigate each component of the form with ease.

Follow the steps to complete the Flm Form successfully.

1. Click the ‘Get Form’ button to access the Flm Form and open it in your preferred editor.
2. In Part I, provide the proposed authorized user's name along with their Illinois medical license number and any pending radioactive material license number. Make sure to check all applicable authorizations by marking the boxes next to the relevant training references.
3. Move to Part II. If the individual has been previously licensed, fill out Part II(A) with the relevant medical institution's information and the authorized user's contact details. Don't forget to include the institution's radioactive material license number and any necessary attachments.
4. If using the board certification method, complete Part II(B) by listing all relevant board certifications. Ensure you provide evidence of each certification. An attestation from a preceptor is required, detailing the supervision of the training.
5. If opting for the structured training and experience method, fill out Part II(C) by detailing all pertinent training hours and dates for classroom/lab training, work/clinical training, and any specific use/device training.
6. For the certification in Part III, provide the name, title, and signature of the individual acting on behalf of the licensee. Ensure that the date is also included.
7. Review all sections for accuracy. Save any changes, and choose to download, print, or securely share the completed Flm Form as needed.

Complete your Flm Form online today for a seamless filing experience.