32 Ill. Adm. Code 401.APPENDIX E
E Example Letter of Agreement for Nuclear Medicine Advanced Associate
Section 401.APPENDIX E Example Letter of Agreement for
Nuclear Medicine Advanced Associate
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
nuclear medicine advanced associate, 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 physician, licensed by the State of Illinois, whose name appears as an authorized user on Radioactive Materials License
(License Number) issued by the Illinois Emergency Management Agency.
Sincerely,
Physician's Name
(Typed)