NV.gov
INFORMATIONAL NOTICE
Attestation Forms
License Application Forms
Registration Application Forms
-
- Registration Form for CT or Fluoroscopy prior to 1-1-2020 (Click here to access our online system)
- Registration Form for Radiation Therapy or Radiologic Imaging prior to 1-1-2020 (Click here to access our online system)
- Registration form for Rural Authorization (Click here to access our online system)
- Registration Form for the holder of a license to engage in Computed Tomography for Qualifying (Click here to access our online system)
- Registration Form for the holder of a license or limited license to practice outside of scope (Click here to access our online system)
Technologists Fees
Per LCB File No. R043-20 and R074-19, Adopted Regulations
Mammography Application Forms
General Forms
- Notice to Employees Form
- Mammographer Certificate of Authorization Application (Click here to access our online system)
- Mammography Technologist Change of Information (Click here to access our online system)
- Mammography Technologist Termination Request (Click here to access our online system)
- Mammography Machine Application for Certificate of Authorization (Click here to access our online system)
- Mammography Machine Application for Certificate of Authorization - Addendum 1
- Mammography Machine Application for Certificate of Authorization - Addendum 2
- Mammography Machine Application for Certificate of Authorization - Addendum 3
- Non-MQSA Mammography Machine Annual Registration Form
- Mammography Physicians Supplement
- Template for Physician Experience