REGULATIONS
Vol. 37 Iss. 13 - February 15, 2021

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING
BOARD OF MEDICINE
Chapter 101
Forms

REGISTRAR'S NOTICE: Forms used in administering the regulation have been filed by the agency. The forms are not being published; however, online users of this issue of the Virginia Register of Regulations may click on the name of a form with a hyperlink to access it. The forms are also available from the agency contact or may be viewed at the Office of the Registrar of Regulations, 900 East Main Street, 11th Floor, Richmond, Virginia 23219.

Title of Regulation: 18VAC85-101. Regulations Governing the Practice of Radiologic Technology.

Effective Date: February 15, 2021.

Agency Contact: Elaine J. Yeatts, Agency Regulatory Coordinator, Board of Medicine, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone (804) 367-4688, or email elaine.yeatts@dhp.virginia.gov.

Summary of Public Comments and Agency's Response: No public comments were received by the promulgating agency.

FORMS (18VAC85-101)

Instructions for Completing an Application for Licensure as a Radiologic Technologist By Examination/Endorsement (rev. 11/10).

Instructions for Completing an Application for Licensure as a Radiologist Assistant (rev. 11/10).

Application for a License as a Radiologic Technologist (rev. 11/10).

Application for a License to Practice as a Radiologist Assistant (rev. 11/10).

Form A, Radiologic Technologist, Claims History Sheet (rev. 11/10).

Form A, Radiologist Assistant, Claims History (rev. 11/10).

Form B, Radiologic Technologist, Activity Questionnaire (rev. 11/10).

Form B, Radiologist Assistant, Activity Questionnaire (rev. 11/10).

Form C, Radiologic Technologist, Clearance from Other States (rev. 11/10).

Form C, Radiologist Assistant, Clearance from Other States (rev. 11/10).

Form E, Radiologist Assistant, Certification Request from ARRT (rev. 11/10).

Form E, Radiologic Technologist, Certification Request from ARRT (rev. 11/10).

Form F, Traineeship Application (rev. 11/10).

Form L, Radiologic Technologist, Certificate of Professional Education (rev. 11/10).

Form L, Radiologist Assistant, Certificate of Professional Education (rev. 11/10).

Instructions for Completing an Application for Licensure as a Radiologic Technologist-Limited (rev. 11/10).

Application for a License to Practice Radiologic Technology-Limited (rev. 11/10).

Form T/A (1) and T/A (2), Radiologic Technologist-Limited Training Application for Abdomen/Pelvis pursuant to Virginia Regulations 18VAC85–101–60 B (3) (rev. 11/10).

Form T/C (1) and T/C (2), Radiologic Technologist-Limited Clinical Training Application (rev. 11/10).

Form T/E, Radiologic Technologist-Limited Traineeship Application (rev. 11/10).

Form A, Radiologic Technologist-Limited, Claims History Sheet (rev. 11/10).

Form B, Radiologic Technologist-Limited, Activity Questionnaire (rev. 11/10).

Form C, Radiologic Technologist-Limited, Clearance From Other States (rev. 11/10).

Instructions for Completing Reinstatement of Radiologic Technology Licensure (rev. 8/07).

Application for Reinstatement of License to Practice Radiologic Technologist (rev. 10/07).

Instructions for Completing Reinstatement of Radiologic Technologist-Limited Licensure (rev. 8/07).

Application for Reinstatement of License to Practice Radiologic Technologist-Limited (eff. 10/07).

Application for Registration for Volunteer Practice (rev. 8/07).

Sponsor Certification for Volunteer Registration (rev. 8/08).

Application to Practice as a Radiologic Technologist, Limited Radiologic Technologist, or Radiologist Assistant, online application available at https://www.license.dhp.virginia.gov/apply/

Instructions for Completing an Application to Practice as a Radiologic Technologist in Virginia (rev. 12/2017)

Instructions for Completing an Application to Practice as a Limited Radiologic Technologist in Virginia (rev. 12/2017)

Instructions for Completing an Application to Practice as a Radiologist Assistant in Virginia (rev. 12/2017)

Form B, Activity Questionnaire (rev. 7/2017)

Supplemental Form to Form B (rev. 9/2018)

Form C, Radiologic Technologist/Radiologist Assistant, Clearance from Other States (rev. 11/2010)

Form B, Certificate of Professional Education (rev. 8/2007)

Instructions and Application for Reinstatement of a License to Practice as a Radiologic Technologist/Limited Radiologic Technologist (rev. 12/2019)

Application for Registration for Volunteer Practice (rev. 8/2015)

Sponsor Certification for Volunteer Registration (rev. 7/2018)

Continued Competency Activity and Assessment Form (eff. 7/08).

VA.R. Doc. No. R21-6643; Filed January 24, 2021