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, 191KB)
RC 252-2 Radioactive Material License (PDF, 67KB)
RC 252-4Certificate of Disposition (PDF, 206KB)
RC 256-1aRSO via Board Certification (PDF, 156KB) 
RC 256-1bRSO via Hours (PDF, 151KB) 
RC 256-1c
RSO via AU (PDF, 122KB) 
RC 256-2aAMP via Board Certification (PDF, 146KB) 
RC 256-2b
AMP via Post Grad Degree (PDF, 156KB) 
RC 256-3a
ANP via Board Certification (PDF, 129KB) 
RC 256-3b
ANP via Hours (PDF, 138KB) 
RC 256-4a
AU for 256ff and hh Uses via Board Certification (PDF, 156KB) 
RC 256-4b
AU for 256ff, hh and ddd Uses via Hours (PDF, 168KB) 
RC 256-5a
AU for 256kk Uses via Board Certification (PDF, 179KB) 
RC 256-5b
AU for 256kk Uses via Hours (PDF, 186KB) 
RC 256-6a
AU for 256rr and ddd Uses via Board Certification (PDF, 148KB) 
RC 256-6b
AU for 256rr and ddd Uses via Hours (PDF, 179KB) 

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 February 2, 2018