Louisiana State Radiologic Technology Board of Examiners

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Louisiana State Radiologic Technology Board of Examiners
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Policies

ADA Policy
Applicant's Oath
Code of Ethics
Evaluation for Impairment & Licensure Fitness Policy
Fee Schedule
License Auditing Policy
Licensee Health Monitoring Policy
Sexual Harassment Policy

Paper Forms

NMTCB Authorization for Disclosure of Information
ARRT Authorization for Disclosure of Information
Affidavit of Compliance
Application for Renewal (2026-2028)
Attestation of Program Completion
Authorization for Release of Employment and Personnel Records
Authorization for Release of Protected Health Information (PHI) (All Records)
Authorization for Release of Protected Health Information (PHI) (Psychotherapy Records)
Complaint / Self-Report Form
Duplicate License Certificate Request
Employment Verification Form
Hardship Exemption Request
Inactive Status Request
License Combination Request
License Registry Request
LXMO Program Application
Name Change Request
Official License Verification
Petition for Rulemaking Request
Pre-Application Eligibility Request
Recovery Meeting Attendance Form

Digital Forms

Attestation of Program Completion Digital Form
Digital Authorization for Release of Employment and Personnel Records
Digital Authorization for Release of Protected Health Information (All Records)
Digital Authorization for Release of Protected Health Information (Psychotherapy Records)
Complaint / Self-Reporting Digital Form
Hardship Exemption Digital Request Form
Inactive Status Digital Request Form
Name Change Digital Request Form
Petition for Rulemaking Digital Request Form
Pre-Application Eligibility Digital Request Form
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