Fluoroscopy operator forms R-50, R-51 & R-52

For questions about completing this form:
Please call 303-692-3448
Physician assistant and nurse practitioners application category.
Please indicate the category for your application *
Cath lab specialist application category.
 +
Please check all that apply:

Payment method

Applicant information

Enter your first and last name exactly as it appears on the government-issued ID you are bringing to the testing site. The address you enter in this section is where the AART testing packet will be sent.

Employer information

Instruction/education/continuing education affirmation

Instruction/education/continuing education requirement (Colorado Rules and Regulations Pertaining to Radiation Control, 6 CCR 1007-1, Part 2, Appendix 2O, Section 2O.1.1)

The student must complete at least 40 hours of in-person or online instruction/education/continuing education training in the following topics: radiation physics, radiation biology, radiation safety, and radiation management applicable to fluoroscopy.
 +
 +

Cath lab specialist confirmation of certification

Affirmation of supervision.

Clinical requirement

 +
 +

Examination module
If you need special accommodations, please review the information on disability accommodations related to ARRT testing.

Required uploads








Signature and final affirmation

As a Colorado registered Fluoroscopy Operator, I affirm that I have completed the requirements as outlined in Appendix 2O, Section 2O.1.1 and section 2O 1.2. I also understand that if I do not meet the requirements of Appendix 2O, I will no longer be a Fluoroscopy Operator.
Student affirmation
I certify by my signature below, under penalty of law, this application is prepared in conformity with the Colorado Department of Public Health and Environment’s 6CCR 1007-1 Rules and Regulations pertaining to Radiation Control and that all information contained herein, including any attachments is true, accurate and complete to the best of my knowledge and belief. I understand I must be approved as a Fluoroscopy Operator before independently performing fluoroscopy procedures in the State of Colorado.
For the purposes of this form, the Colorado Department of Public Health and Environment accepts your typed name, title and date as an electronic signature equivalent to your valid signature on a paper copy of the form. As such, this electronically completed form subjects the signatory to the same responsibilities as a hand-signed form. Per Section 18-8-306, C.R.S., it is a felony to submit false information to a state official.
 +
Powered byFormsite
Accessibility statement and support page