Applications and Forms - Radioactive Materials Licensing

Radioactive Materials Licenses

Radioactive Materials Applications and Forms
Document Number Title
CI-40 General License Acknowledgement Self-Evaluation Form (PDF, 103KB)
RC 251-2 General License Acknowledgement of Devices Containing Radioactive Material (PDF, 92KB)
RC 252-1 Business Information Form - License (PDF, 54KB)
RC 252-2 Radioactive Material License (PDF, 67KB)
RC 252-2a Radioactive Material License - Medical Uses (PDF, 95KB)
RC 252-2b Preceptor Statement for License Application - Medical (PDF, 93KB)

Notice to Employees

Notice to Employees
Document Number Title
RC 203-1 Notice to Employees (PDF, 10KB)
RC 232-1 Notice to Employees (Dentists Only) (PDF, 9KB)
RC 233-2 Notice to Employees (Vets Only) (PDF, 64KB)

Training and Qualification

Training and Qualification Documents
Document Number Title
RC 255-C Accepted Radiation Safety Training Courses (PDF, 66KB)

Licensing Reciprocity

Licensing Reciprocity Forms
Document Number Title
RC 252-3 Notice of Intent to Work in Texas Under Reciprocity (PDF, 27KB)
Submit by FAX only. Please review the “Sensitive Information” notice on the form

Last updated July 25, 2017