X-ray Unit Examination Process: Fill out & sign online

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Click ‘Get Form’ to open the X-ray Unit Examination Process in the editor.
Begin by filling out the Applicant section. Ensure all fields are completed, including your First Name, Last Name, Date of Birth, and Social Security Number.
Provide your Home Address, City/State/Zip, Phone Number, and Email. This information is mandatory for processing your application.
In the Exam Training section, indicate the School attended and any Training/Classes completed relevant to your examination.
Select at least one module under the Core Exam and Modules section. You must check a box for either Chest, Extremity, Podiatry, Skull/Sinus, or Spine.
If applicable, check any modules you wish to retake in the Retake Core Exam section.
Attach a $25.00 money order or cashier’s check for the MDH Processing Fee before submitting your application.
Finally, sign and date the application to confirm that all provided information is true and complete.

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