Get Ca Cdph 8391 2024-2026

The CA CDPH 8391 form is essential for individuals holding specific radiologic certifications in California to report any changes in their name or address. This guide provides clear instructions on how to complete the form online, ensuring a smooth submission process.

Follow the steps to fill out the CA CDPH 8391 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Review the individual's certification type. Check the box corresponding to your current application status, whether you are applying for a certificate or taking a State examination.
3. Enter your current certificate or permit number in the designated field.
4. Provide your date of birth in the available field to verify your identity.
5. Fill out your social security number or individual taxpayer identification number as required.
6. In the ‘Previous Name and Address’ section, input your old name and address details including the city, state, and zip code.
7. In the ‘Current Name and Address’ section, fill in your new name and address with the city, state, and zip code.
8. Provide your daytime telephone number and email address for contact purposes.
9. Sign and date the form in the appropriate fields to validate your submission.
10. If you are requesting a duplicate certificate or permit, ensure to check the appropriate box and include the required payment information.
11. Once you have completed the form, you can save your changes, download or print the form, or share it as needed.

Complete your CA CDPH 8391 form online today for a hassle-free name or address change!