Applications and Forms

Table of Contents

X-Ray Machines

Document Number Title
 RC 17-R  Termination Form 
 RC 42-I  Industrial Radiation Safety Officer (RSO) Form
 RC 42-IR  Industrial Radiography Radiation Safety Officer (RSO) Form
 RC 42-R  Radiation Safety Officer (RSO) Form
 RC 204  Radiation Machine Source Unit Fee Schedule
 RC 226-01  Business Information Form - Registration
 RC 226-02  Radiation Machine Application - New & Renewal
 RC 226-03  Radiation Machine Application - Amendment
 RC 226-04  Industrial Radiation Machine Application - New, Reciprocity, & Renewal
 RC 226-05  Industrial Radiation Machine Application - Amendment
 RC 226-06  Radiation Machine Services Application - New, Renewal, & Amendment
 RC 226-08  Mobile Services
 RC 226-09  Coronary Calcium Screening
 RC 226-10  Osteoporosis Screening
 RC 226-11  CT Lung Screening
 RC 229-01  Additional Information for Accelerator Registration
 RC 229-02  Electronic Brachytherapy Registration
 RC 229-03  Superficial Radiation Therapy (SRT) Registration

Equipment Performance Evaluation

Please contact Trae Windham via email or telephone at (737) 218-7084, about any other inspection forms.

Document Number Title
EPEDent-1 Equipment Performance Evaluation, Dental Radiographic Unit (PDF, 776KB)
EPERad-1 Equipment Performance Evaluation, Radiographic Unit (PDF, 92KB)
EPEVet-1 Veterinary Equipment Performance Evaluation (PDF, 72KB)

Notice to Employees

Document Number Title
RC 203-1 Notice to Employees 
RC 232-1 Notice to Employees (Dentists Only) 
RC 233-2 Notice to Employees (Vets Only) 

Licensing Reciprocity

Document Number Title
None Notice of Intent to Work in Texas Under Reciprocity - Non Industrial-Radiography (PDF, 132KB)
None Notice of Intent to Work in Texas Under Reciprocity - X-Ray Services (PDF, 204KB)