Get Or Permanent Renewal Lxmo Permit 2017-2026

The OR Permanent Renewal LXMO Permit is essential for individuals seeking to maintain their licensure in radiologic technology in Oregon. This guide provides clear instructions for completing the permit application online, ensuring users can navigate the process effectively and without confusion.

Follow the steps to successfully complete your permit application online.

1. Press the ‘Get Form’ button to access the OR Permanent Renewal LXMO Permit. This will open the form in an online editor for you to fill out.
2. In Part 1, provide your personal details. Fill in your last name, first name, middle name, driver’s license number, social security number (mandatory), maiden name, state issued in, and your OBMI number if applicable.
3. Move to Part 2 to enter your contact information. Include your mailing address or P.O. Box, city, state, cell phone number, home phone number, home email address, and work email address.
4. Proceed to Part 3, where you will provide information regarding your current or prospective Oregon employer. Fill in the employer's name, address, city, zip code, supervisor's name, work phone number, and the start date as an LXMO permit holder.
5. Complete Part 4 by providing the name of the supervising practitioner. This individual must be a licensed physician, nurse practitioner, or licensed physician assistant. Obtain their signature, printed name, degree, and the date.
6. In Part 5, declare your personal background history. Answer the following questions truthfully regarding any arrests or convictions, and disclose necessary documents if you have a criminal history.
7. Part 6 requires you to agree to abide by Oregon laws and rules related to medical imaging practices, confirming your understanding of the information provided and your contact obligation.
8. In Part 7, provide proof of continued education. Attach copies of your continuing education certificates as specified, ensuring you meet the hour requirements for renewal.
9. Review your completed application for accuracy. Once all sections are filled, save your changes. You can download or print the form to mail it to the Oregon Board of Medical Imaging along with the necessary fees and documents.

Complete the OR Permanent Renewal LXMO Permit application online now to ensure your license remains valid.