Get Pa Application For Authorization To Perform Radiological Procedures 2013-2025

This guide provides step-by-step instructions on how to complete the PA Application for Authorization to Perform Radiological Procedures online. Whether you are familiar with online forms or a first-time user, this guide will support you in filling out the application accurately.

Follow the steps to complete your application efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter your personal information in the fields provided. This includes your last name, first name, and middle name. Ensure accuracy as this information will be used for official purposes.
3. Fill in your address details, including the street, city, state, and zip code. Double-check these entries to ensure they are correct.
4. Provide your social security number in the designated format (XXX-XX-XXXX). This is required for identification purposes.
5. Input your date of birth using the format month/day/year. This helps verify your eligibility.
6. Enter your phone number in the area code and number format. This allows the board to contact you if needed.
7. Include your email address. Make sure it is current as important updates will be sent to this address.
8. Indicate the examination date, as it is essential for processing your application.
9. Attach a check or money order for $75.00 made out to 'Commonwealth of PA'. Remember, cash should not be sent.
10. Ensure that all information is complete and accurate before saving your changes. You may then download or print your application for submission.
11. Retain a copy of the submitted application and the payment confirmation for your records.

Start filling out your PA Application for Authorization to Perform Radiological Procedures online today!