Healthy Communities

Radiologic Technology Licensure Forms

Fill out the appropriate application or renewal form, electronically if available. Sign the form where appropriate and mail it along with any applicable fee to the address indicated on the form. Other forms are as indicated below.

Downloads
Application for Licensure
Limited Scope Examination Application - Effective January 1, 2015
Temporary Application for Licensure
License Renewal Form
Complaint Form
Inactive-Retired Status Request Form

Public Health Accrediation Board
Arkansas Department of Health
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4815 W. Markham, Little Rock, AR 72205-3867 | 1-800-462-0599