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Applications & Forms

SCRQSA Applications and Forms

The following SCRQSA Applications and Forms may be downloaded for your use. 

Please visit the Frequently Asked Questions pages for information on certification questions. 

Should you have any questions, please contact SCRQSA office at 877-771-6141 or

Certification Forms

Application for Certification
Application for Recertification
2018 Recertification Process - How To Letter

Exam Applications

Limited Certification Examination Application
Bone Densitometry Examination Application

State Radiography, Radiation Therapy or Nuclear Medicine Examination Application

Other Forms  

Name Change/Change of Address/Reprint
Continuing Education Approval Form

Updated Statement on PET/CT Certification (2018)
Violations Reporting Form
Mailing List

Competency Checklists

CLR - General Competency Checklist
CLR-Chiropractic Competency Checklist
CLR - Chest Competency Checklist
CLR - Podiatric Competency Checklist

Scope of Practice

Limited Radiographer's Scope of Practice
Updated Statement on PET/CT Certification (2018)

The SCRQSA Board acknowledges the Scope of Practice of the American Society of Radiologic Technologist for all modalities covered by the ARRT, NMTCB or RCIS unless otherwise adopted by the board for a specific procedure.


South Carolina Radiation Quality Standards Association
P.O. Box 7515
Columbia, SC 29202
1300 12th Street, Suite B, Cayce, SC 29033
Toll-Free (877) 771-6141
(803) 771-6141  (803) 771-8048 Fax