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A completed field indicates a change. Business Phone Number Type of Facility Business or Practice e.g. dental medical veterinary etc. Mailing Address street number and name No Longer a Mammography FOR RADIOLOGIC HEALTH BRANCH USE ONLY RH 2261C 11/14 Page 1 of 5 Manufacturer Model Room Name or Number Registered Machine Changes provide new or corrected information only Number of X-ray Tubes Waveguides or Electron Guns Type Code Additional Informati.

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How to fill out the Rh2261c online

Filling out the Rh2261c form is essential for registering changes related to radiation machines and registrants in California. This guide will walk you through each section of the form, ensuring clarity and accuracy while you complete it online.

Follow the steps to accurately fill out the Rh2261c form.

  1. Click the ‘Get Form’ button to obtain the Rh2261c form and open it in the digital editor.
  2. Begin with Section A: Registrant Information. Fill in the name of the facility, business, or practice, the physical address, registration number, city, state, and zip code.
  3. For changes in registrant information, complete Section B with new or corrected information, including the business phone number and the type of facility.
  4. If changes involve registered machine information, proceed to Section C. Provide details such as the manufacturer, model, room name or number, and any changes to registered machine details.
  5. If removing any registered machines, complete Section D. Indicate whether the machine is no longer in your possession or has been made incapable of producing radiation.
  6. To add machines, fill out Section E. Include the manufacturer, model, type code, and acquisition date for each new machine being registered.
  7. In Section F, provide the contact information for the person who can be reached regarding any inquiries about the form.
  8. Sign the form in Section G, confirming the information is true and correct. Include your name, title, signature, and date.
  9. Finally, review all the entered information, save the changes, and either download, print, or share the completed form as needed.

Complete your Rh2261c form online today to ensure your radiation machine registrations are up to date.

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Related content

Radiation Machine Registration - CDPH - CA.gov
For Changes to existing registrations - Request form RH 2261C. 3. For Withdrawal of (e.g...
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