New Hampshire Code of Administrative Rules
Mirt - Board of Medical Imaging and Radiation Therapy
Chapter Mirt 300 - REQUIREMENTS FOR LICENSURE
Part Mirt 302 - APPLICATION PROCEDURE
Section Mirt 302.04 - Required Documents
Current through Register No. 12, March 21, 2024
Applicants for initial licensure as a limited x-ray machine operator, medical imaging professional, or radiation therapist shall provide, or arrange for the board to receive, the following documents supporting their applications:
(a) A recent passport size, 2" x 2", original head-shot photograph;
(b) On a separate sheet, a detailed report of the relevant circumstances if any of the answers to questions described in Mirt 302.02(f)(1)-(7) on part one of the application form is in the affirmative;
(c) On a separate sheet, a detailed report of the relevant circumstances if any of the answers to questions in Mirt 302.02(i)(1)-(5) on part 2 of the application form is in the affirmative;
(d) Unless the information sought is available only on a website, an official letter of verification sent directly to the board from every jurisdiction which has issued a license or other authorization to practice stating whether:
(e) A photocopy of the applicant's national certification card bearing the appropriate certification for the applicant's modality, which shall be verified upon receipt;
(f) The documents required for the criminal history records check pursuant to RSA 328-J:7-a shall include either:
(g) A resume presenting a chronologically organized account of the applicant's paid and voluntary work experience in the applicant's field of medical imaging or radiation therapy for the prior 5 years. The period of each separate experience shall be designated by its beginning and end dates, and the city and state of each experience shall be listed; and
(h) Proof of education, which shall be: