Texas Board of Licensure for Professional Medical Physicists Application-Forms

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Select the link below for the complete application/form for Licensed Medical Physicists:

Application for Licensure Packet for a Professional Medical Physicist (Word format, 175 KB)
Application for Licensure Packet for a Professional Medical Physicist (Adobe Acrobat format, 177 KB)

Renewal Form for Medical Physicist (Word format, 65 KB)
Renewal Form for Medical Physicist (Adobe Acrobat format, 28 KB)

Temporary Medical Physicist Renewal - Request for Supervision/Action Plans Form (Word format, 70 KB)
Temporary Medical Physicist Renewal - Request for Supervision/Action Plans Form (Adobe Acrobat format, 60 KB)

Application to Upgrade Temporary License (Word format, 84 KB)
Application to Upgrade Temporary License (Adobe Acrobat format, 68 KB)

Professional Reference Form (Word format, 39 KB)
Professional Reference Form (Adobe Acrobat format, 31 KB)

Agreement of Supervision Form (Word format,  88 KB)
Agreement of Supervision Form (Word format,87 KB)

Verification of Licensure (Word format, 34 KB)
Verification of Licensure (Adobe Acrobat format, 18 KB)

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Last updated September 17, 2014
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    Professional Medical Physicists