Radiologic Technologist Qualification Worksheet 2026

1. Click ‘Get Form’ to open the Radiologic Technologist Qualification Worksheet in the editor.
2. Begin by filling in your General Radiography License details, including the state and expiration date. Ensure accuracy for a smooth processing experience.
3. Indicate whether your initial qualifications were met before or after 4/28/99 by checking the appropriate box.
4. Complete the section on mammography training. If you have completed the required 40 hours of training, provide the course name and number.
5. Fill in your Continuing Qualifications by documenting the number of mammography exams performed in the last 24 months and any relevant CEUs earned.
6. Finally, enter your personal information, including your name, place of employment, trainer's name, and IDPH approval date.

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