Ariz. Admin. Code § R9-16-614 - Application for Computed Tomography Technologist Preceptorship and Temporary Certification

A. Before beginning training under R9-16-613(A)(3)(b), an individual shall obtain a computed tomography preceptorship certificate from the Department.

B. An applicant for a computed tomography preceptorship certificate shall submit an application to the Department that includes:

1. The information and documents required under R9-16-619;

2. A Department-provided agreement form from a radiologist, licensed under A.R.S. Title 32, Chapter 13 or 17 and certified in radiology by the American Board of Radiology, that includes the following:

a. The name and date of birth of the applicant;

b. The name, license number, e-mail address, and telephone number of the licensed radiologist;

c. A statement that the licensed radiologist is accepting responsibility for the applicant's supervision and training; and

d. The licensed radiologist's signature and date of signing; and

3. The applicable fee in R9-16-623.

C. The Department shall approve or deny an individual's application for a computed tomography preceptorship certificate according to R9-16-621.

D. A computed tomography preceptorship certificate is valid for one year from the date issued and may not be renewed.

E. At least 30 days before the expiration of an individual's computed tomography preceptorship certificate, the individual may apply for a computed tomography temporary certificate by submitting an application to the Department that includes:

1. The information and documents required under R9-16-619;

2. A Department-provided agreement form from a radiologist, licensed under A.R.S. Title 32, Chapter 13 or 17 and certified in radiology by the American Board of Radiology, that includes the following:

a. The name and date of birth of the applicant;

b. The name, license number, e-mail address, and telephone number of the licensed radiologist;

c. A statement that the licensed radiologist is accepting responsibility for the applicant's supervision and training; and

d. The licensed radiologist's signature and date of signing; and

3. The applicable fee in R9-16-623.

F. The Department shall approve or deny an individual's application for a computed tomography temporary certificate according to R9-16-621.

G. A computed tomography temporary certificate is valid for one year and may not be renewed.

Notes

Ariz. Admin. Code § R9-16-614

Adopted by final expedited rulemaking at 25 A.A.R. 2409, effective 8/27/2019. Amended by final rulemaking at 26 A.A.R. 351, effective 4/5/2020. Amended by final expedited rulemaking at 31 A.A.R. 672, effective 2/4/2025.