Get Ca Cdph 8391 2017-2026

The CA CDPH 8391 form is essential for individuals in the radiologic field to report changes in their name or address. This guide provides clear instructions on how to accurately complete the form online to ensure compliance with California regulations.

Follow the steps to complete the CA CDPH 8391 online.

1. Press the ‘Get Form’ button to access the CA CDPH 8391 form and open it in your online editor.
2. Indicate your current certificate or permit number in the designated field. This information is crucial as it links your application to your existing records.
3. In the 'Previous Name and Address' section, provide your full name and previous address details including street, city, state, and zip code. This ensures that the Department can accurately identify your historical records.
4. Next, in the 'Current Name and Address' section, fill in your new full name and current address, again including street, city, state, and zip code. It is important that these details reflect your up-to-date information.
5. Complete the daytime telephone number and email address fields. Providing these helps the Department contact you if there are questions regarding your submission.
6. Sign the form in the signature field and enter the date you are completing the form. Your signature verifies the accuracy of the information provided.
7. If you are requesting a duplicate of your permit or certificate, include a check or money order for the required amount: $2 for most certificates or $18 for Nuclear Medicine Technologist certificates.
8. Once all sections are completed, review your form carefully to ensure all information is accurate before saving, downloading, printing, or sharing your form as necessary.

Complete your CA CDPH 8391 form online today to ensure timely processing of your name or address change.