Get Radtech Customer Order Form - Nmenv State Nm

Filling out the RADTECH Customer Order Form accurately is essential for renewing your NM license. This guide provides clear instructions on each section of the form, ensuring a smooth online submission process.

Follow the steps to complete your RADTECH Customer Order Form online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred PDF editor.
2. Begin by entering your NM Registration Number in the designated field. If you do not have one, you may leave this field blank.
3. Provide your personal details, including your birth date and name (first and last). Ensure that the information matches your official documents.
4. Fill in your address, city, state (abbreviated), and zip code. Enter your home and cell phone numbers for contact purposes.
5. Include your ARRT and NMTCB numbers, if applicable. Also, indicate your ARRT credentials and any legal name change requests, providing the necessary documentation.
6. Select the appropriate checkboxes based on your renewal needs, indicating if you are renewing a full NM license or a limited X-ray machine operator's license, and enter relevant license numbers.
7. For additional copies of certification, indicate the number required and add the corresponding fee.
8. List the facilities where you are applying ionizing radiation on humans for diagnostic purposes, including their physical addresses and telephone numbers.
9. Calculate the total fee by reviewing your selected options and any additional requests. Enter this amount in the specified box and provide your check or money order number.
10. Review all information for accuracy, print the completed form, sign, date it, and prepare to send it along with all required supporting documents and fees to the New Mexico Environment Department.
11. Finalize your process by saving changes to your document, downloading it, or printing it for mailing. Ensure all components are ready before submission.

Complete your RADTECH Customer Order Form online today to ensure timely processing of your license renewal.