D Example Letter of Agreement for Radiologist Assistant

Section 401.APPENDIX D   Example Letter of Agreement for Radiologist Assistant Technologist Accreditation Program Illinois Emergency Management Agency 1035 Outer Park Dr. Springfield IL  62704 Re:  (Name of Applicant) To whom it may concern: This letter is to serve as acknowledgement that (Name of Applicant) will be employed by (Name of Radiology Group or Facility) under my supervision.  (Name of Applicant) will, as a radiologist assistant, perform a variety of activities in the areas of patient care, patient management, clinical imaging and interventional procedures.  It is also recognized that (he/she) may not interpret images, make diagnosis or prescribe medications or therapies. I am a radiologist, licensed by the State of Illinois as a physician, and certified by the American Board of Radiology or the American Osteopathic Board of Radiology (select the appropriate Board). Sincerely, Physician's Name (Typed)