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Forms

Available online x-ray equipment forms

Forms

Electronic Application for Registration of Radiation-generating Equipment

Electronic Amendment of Radiation-generating Equipment

HEA5508 Notice of Termination of Entire Facility's Registration to Possess Radiation-generating Equipment

HEA0152 Radiation-generating Equipment Source Address Change Request

HEA5526 Individual Responsible for Radiation Protection (IRRP) Change Request

Revised 11/2015

 

HEA5503 Notice to Employees

Revised 11/2017

HEA5139 Application for Self-Referral Screening of Radiation-generating Equipment

Revised 6/2015

 

Self-Referral Amendment Application

Revised 5/2022

 

HEA5530 Confidential Employer's Presumptive Overexposure Report

Revised 2/1998

 

Lists

Disposal Companies and Charitable Organizations