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Radiologic Technologist Forms and Documents

Contact the Bureau of Radiation Control

All files are 500 KB or less unless otherwise specified.

  • DH Form 1005, version 10/12, adopted June 11, 2013, in rule 64E-3.003, FAC
    Application form and instructions for certification as a General Radiographer, Nuclear Medicine Technologist, Radiation Therapy Technologist, Radiologist Assistant, or in Computed Tomography, Mammography, or Magnetic Resonance Imaging. The PDF also includes the background history report form (DH 4127),and license verification form (DH 4128).

  • DH Form 1006, version 10/09, adopted February 18, 2010, in rule 64E-3.003, FAC
    Application form for certification as a Basic X-ray Machine Operator or Basic X-ray Machine Operator-Podiatric. Also includes application instructions and background history report form (DH 4127), and license verification form (DH 4128).

  • DH Form 4127, version 10/07, adopted March 4, 2008, in rule 64E-3.003, FAC
    Background History Report Form.

  • DH Form 4128, version 10/07, adopted March 4, 2008, in rule 64E-3.003, FAC
    License Verification Form.

  • RT Programs List
    List of Accredited Radiologic Technology (RT) Training Programs in Florida, August 2013.

  • Certification Act "Blue Book"
    Radiological Personnel Certification Act "Blue Book". Contains all statutes and regulations governing the professions, in printable booklet form. This includes Chapter 468, Part IV, FS. and Chapter 64E-3, FAC. Also includes the ARRT "Radiologist Assistant Role Delineation, Jan. 2005", incorporated by reference.

  • Content Specifications
    Content Specifications for all of the ARRT's radiologic technology examinations. The department uses these exams for Florida certification.

  • DH Form 374, version 10/07 Adopted March 4, 2008
    Request for Approval of Continuing Education Course (for CE Provider Use).

  • Provider Guidelines
    Guidelines and Requirements For Providers of Continuing Education Courses (for CE Provider Use).

*Note: This page contains materials in the Portable Document Format (PDF). The free Adobe Reader may be required to view these files.