ARMRIT RENEWAL 2018-2020

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Tech's Name:

Tech's ARMRIT Certificate number:

Email:

Address

City

State

Zip

Phone

Work Phone

Employer

City

State

Equipment Experience

Renewal was due by November 15, 2017. Include the following:

1) Three-year Renewal fee (including late fee after November 15, 2017) of $400.00

2) Evidence of at least twenty-four (24) CME credits in MRI Technology performed in 2015, 2016, or 2017.

Proof of CME (24) credits: (choose one): MRI Subjects Only!!!

Already on file:
Will send:

Were you convicted of a felony or misdemeanor since last renewal? YES     NO

If YES, submit details for review.

Please complete the sentence: norobots

*Renewal is mandatory to maintain your Credential & Certification Registry Active status.
**A Certificate and ID Card will not be released until CME evidence is provided.
***Late Fees Apply / Failure to Renew Will Lead to Revocation (see note) after March 14, 2018..
****Not Tax Deductible.
***** Consult your Tax Advisor for Tax Deductibility.

Note: Revocation renders your Credential & Certification null & void requiring completion of an application and sitting for the examination. No exceptions!

Or Click Here for a form to fill out and fax to: 718-347-8691
or mail to:

ARMRIT
2049 E. 67th Street
Brooklyn, NY 11234