Home
Forms Library
SS #: (Last) (Firs - West Virginia Medical Imaging and Radiation - wvrtboard

SS #: (Last) (Firs - West Virginia Medical Imaging and Radiation - wvrtboard 2025

SS #: (Last) (Firs - West Virginia Medical Imaging and Radiation - wvrtboard Preview on Page 1

See details

4.6 out of 5

50 votes

The document is an application form for the renewal of a Podiatry Medical Assistant license issued by the West Virginia Medical Imaging and Radiation Therapy Technology Board of Examiners. It includes sections for personal and employment information, questions regarding child support obligations and felony convictions, and a declaration statement that the applicant must sign.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out SS #: (Last) (First) - West Virginia Medical Imaging and Radiation - wvrtboard

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information. Fill in your last name and first name in the designated fields for 'SS #: (Last)' and '(First)'.
Next, provide your address, including street or P.O. Box, city, county, state, and zip code.
Enter your email address and telephone number in the respective fields.
In the employment information section, list your employer's name and address. Indicate whether you are working full-time or part-time.
Answer the questions regarding child support obligations and felony convictions truthfully. If applicable, provide additional details on a separate sheet.
Finally, read the declaration carefully, sign it, and date it to confirm that all information is accurate.

Start using our platform today to fill out your application easily and for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the difference between radiation therapy and medical imaging?

Medical Imaging Technologists use different technologies to create images to diagnose disease. This includes: X-rays, CT, MRI, Ultrasound and Nuclear Medicine. Radiation Therapists use technology to create images (X-rays CT) and use high energy radiation to treat disease.

How to become an xray tech in West Virginia?

The Radiography program at WVU Hospitals is a two year (22-month) certificate program offering comprehensive clinical and didactic education in Radiologic Technology.