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RADIATION MACHINE REGISTRATION AND MAMMOGRAPHY FACILITY CERTIFICATION
Radiation
Machine Registration - RH 2261 (07/07)
• Use of form RH 2261 is for initial
and/or modification of registration information only.
Application for Mammography Certification - CDPH 8623 (Rev.
08/07)
Mammography
Facility Certification Fact Sheet
Guide
for Acquiring Radiation Machines Operating in Excess of 500 kVp
CERTIFICATION (Healing Arts)
Syllabus
on Radiography Radiation Protection ( >15
minutes to download @ 28.8 kbps)
Report of
Name or Address Change
Accommodation
Request - CDPH 8625 (Rev 07/07)
• Use this form to provide documentation
of a disability that would require accommodation in testing.
THE FORMS BELOW ARE FOR INITIAL CERTIFICATE OR
PERMIT APPLICATIONS.
If you need to renew go to
Frequently Asked
Questions About Certification and Registration
and select
Renewing my certificate/permit.
Initial Application for Supervisor and Operator Permits -
CDPH 8230 Rev. 09/07
Initial Application for a California Radiology Supervisor and
Operator Certificate - CPDH 8231 Rev. 09/07
Radiologic Technology
Certificate Application - CDPH 8200
(Rev 05/07)
• Use this form to apply for either the diagnostic or therapeutic
radiologic technology certificate.
Radiologic Technologist
Fluoroscopy Permit Application - CDPH 8218 (Rev 07/07)
Syllabus
on Fluoroscopy Radiation Protection ( >15
minutes to download @ 28.8 kbps)
X-ray
Technician Limited Permit Application - CDPH 8232 (07/07)
X-ray
Technician Bone Densitometry Permit Application - CDPH
8232 BD (07/07)
Application for a Certificate in Mammographic Radiologic Technology -
CDPH 8200M (Rev 07/07)
Nuclear
Medicine Technologist Certificate Application - CDPH 8435 (07/07)
SCHOOL APPROVAL
This site is under construction.
Please contact
Marilyn Cantrell at marilyn.cantrell@cdph.ca.gov to obtain an application for the
radiologic technology, fluoroscopy, therapy, limited permit, or bone
densitometry school.
List of Approved
Schools - (Rev. 03/08)
Approved School Students Report -
CDPH 8696 (07/07)
Report of Change of Information for Approved Schools -
CDPH 8697
(07/07)
COMPLIANCE REQUIREMENTS
Notice
to Employees: RHB 2364 (Rev
07/07)
Radiation
Safety Complaint Form - RH 1027 (Rev 07/07)
Diagnostic
Misadministration Report - CDPH 8453 (Rev 07/07)
RADIOACTIVE MATERIALS LICENSING
FEES
(REVISED 2005)
Important
Notice Regarding Termination of a License to Possess Radioactive Materials
Application for Radioactive Materials License - Medical
User Application - RH 2000
(Rev 07/07)
Training and Experience
- RH 2000A (Rev 10/99)
Application for Teletherapy Authorization
-RH 2000D
(Rev 07/07)
Application Guide for Medical
Programs
Radioactive Material License Application Use of Sealed Sources in
Radiography - RH 2050IR (Rev 07/07)
Radiographers Training
and Experience - RH 2050 RA (Rev 07/07)
List of 40-Hour
Industrial Radiography Trainers
Radioactive
Materials License Application - RH 2050
(Rev 07/07)
Radioactive Material User Training
and Experience - RH 2050A (Rev 07/07)
Certificate of Disposition
of Radioactive Material - RH 5314 (Rev
07/07)
Guide for Applicants for a Radioactive Material License - RH 2051 (Rev
07/07)
HDR Guide Rev. 3
Microsphere Guide Rev. 3
Decay in Storage Application Checklist
Gas Chromatograph Application Checklist
Fixed Gauge Application Checklist
Portable Gauge, (Moisture/Density) Application
Checklist
Large Irradiator Application Checklist
Small Irradiators Application Checklist
Krypton-85 Leak Test System Application
Checklist
Large and Medium Laboratory Application
Checklist
Small Laboratory Application Checklist
Sealed
Source and Device Registration Checklist
Veterinary Licensing Guide
Veterinary Duties and
Responsibilities Form
Well Logging and Tracking
Application Checklist
X-Ray Fluorescence Device Application
Checklist
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