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Applications and Forms - X-Ray Registration and Services

Table of Contents

X-Ray Machines

X-Ray Machines Applications and Forms
Document Number Title
LRS-35 Additional Information for Accelerator Registration, Includes Shielding Form (PDF, 21KB)
RC 17-R Request for Registration Termination (PDF, 24KB)
RC 18-R Radiation Machine Transfer/Disposal Form (PDF, 16KB)
RC 42-3 Radiation Safety Officer (RSO) Information for Registration (PDF, 301KB)
RC 42-4 Industrial Radiation Safety Officer (RSO) Form (PDF, 558KB)
RC 42-5 Industrial Radiography (IR/NDT) Radiation Safety Officer (RSO) Form (PDF, 40KB)
RC 204 Schedule of Biennial Fees for Registration for Radiation Machines (PDF, 25KB)
RC 226-1 Business Information Form - Registration (PDF, 24KB)
RC 226-2 Registration Application for Users of Radiation Machines in Healing Arts, Veterinary Medicine and Academic Facilities (PDF, 27KB)
RC 226-3 Registration Application for Industrial Radiation Machines (PDF, 32KB)

Instructions for RC 226-3 Registration Application (PDF, 508KB)
RC 226-5 Registration Application for Radiation Machine Services (PDF, 320KB)

Instructions for RC 226-5 Registration Application (PDF, 453KB)
RC 226-8 Excerpt from 25 Texas Administrative Code (TAC) Section 289.226(g). Mobile Service Operation (PDF, 41KB)
RC 226-9 Authorization for Self-Referred CT Coronary Calcium Screening (PDF, 48KB)
RC 226-10 Healing Arts Screening Requirements for Osteoporosis (PDF, 18KB)
RC 226-11 Authorization for Self-Referred Low Dosage CT Lung Cancer Screening (PDF, 35KB)

Equipment Performance Evaluation

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

Equipment Performance Evaluation 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

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)

Licensing Reciprocity

Licensing Reciprocity Forms
Document Number Title
RC 252-1 Business Information Form - License (PDF, 54KB)
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)
Last updated November 19, 2021