Forms & Applications

Radiography, Nuclear Medicine, Radiation Therapy, and Radiologist Assistant Applications*:
 *See below for information regarding reinstatement of a lapsed license.
 
Limited X-ray Machine Operator Applications*:
ATTN LXMO Applicants: If you are applying for a Limited X-ray Machine Operator license and have completed your training out-of-state please contact the KBMIRT office for further instructions on documentation that needs to accompany the application.
 *See below for information regarding reinstatement of a lapsed license.
 
Other Forms:
 
Reinstatement Process: Following the expiration of a license, an individual may apply for reinstatement using the guidelines listed below.  Please note, the $100 reinstatement fee applies in each of the guidelines.  If an individual's name has changed since license expired, documentation of name change is required (i.e. marriage license, divorce decree, etc).
Radiography, Nuclear Medicine, Radiation Therapy, and Radiologist Assistant Reinstatement:

Limited X-ray Machine Operator Reinstatement:

 

Please note: An initial or temporary license application must include the results of a state criminal background check for any state in which the applicant has lived or worked within the past 5 years.  The results must have been completed within 6 months of the application. 

Forms & Applications