Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to obtain the form and open it in an online editor.
2. Begin by selecting the appropriate status for your application. Options include new/first-time applicant, second-year student, renewal, lapsed, reinstatement, add modality only, or expedite.
3. If you qualify as ARRT, NMTCB, ISCD, PET, CT, or RCIS/RCES credentialed, attach a copy of your ARRT verification letter and/or your NMTCB, ISCD or RCIS/RCES credential card(s). If you hold a limited certificate, ensure to provide the required documentation of continuing education hours.
4. Fill in your personal details in the provided sections. This includes your first name, last name, middle initial, mailing address, city, state, zip code, and phone number. If applicable, indicate if there has been a change of address or legal name.
5. Complete the fields for your SCRQSA certificate number, birth date, social security number, and ARRT/NMTB/RCIS/RCES number if you have them. Ensure to use a valid email address that you check regularly.
6. Provide your employment details, including the name of your employer or medical facility and their contact phone number. Indicate if you wish to be excluded from the online directory of certificate holders.
7. Review your application to ensure it is signed and dated. Applications that are not signed will be returned.
8. Submit your payment either by check/money order or online payment. If paying with a credit card, include the card number, expiration date, CVV code, and billing zip code. Ensure the card holder’s signature is included.
9. Once all sections are filled, verify all information for accuracy and completeness to avoid any penalties. You can then save changes, download, print, or share the completed form as needed.

Complete your SCRQSA Application For Recertification online today to ensure timely processing.