Get Ohsu Online Radiology Form

Filling out the Ohsu Online Radiology Form accurately is essential for effective communication and compliance in radiology settings. This guide will walk you through the process, ensuring that all necessary fields are completed with the required information.

Follow the steps to complete the Ohsu Online Radiology Form easily.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Fill in the facility name in the designated field.
3. Enter the telephone number for the facility, ensuring it is current and accurate.
4. Provide the full address of the facility, including city, state, and zip code.
5. List the county where the facility is located.
6. Input the email address for the facility for communication purposes.
7. Indicate the ownership structure by specifying the parent facility or company.
8. Enter the primary responsible person's title and name, typically the radiation safety officer or radiology manager.
9. If there is no named responsible person, list the physicians associated with radiation procedures at the facility.
10. Indicate the facility's average total radiation exposures per month.
11. Identify the most common procedure or exam performed, along with the percentage of total radiation exposures it represents.
12. Repeat step 11 for the second most common procedure or exam.
13. Describe the image processing and acquisition method used at the facility.
14. Provide the name of the physicist or qualified expert overseeing radiation safety.
15. Indicate if routine personnel radiation monitoring (dosimeters) is provided, along with the number of monitored staff if applicable.
16. List the total number of individuals who operate radiation equipment at the facility.
17. Specify the minimum training required for typical facility operators regarding radiation procedures and safety.
18. For each radiation machine, provide the location or room number, type/usage, manufacturer, control model, and control serial number.
19. If more than 12 machines are owned, continue the listing on the additional machines tab.
20. Add any needed explanatory comments in the designated area.
21. Complete the electronic signature section by certifying your authority to complete this form.
22. Enter your title and the date of completion, ensuring legibility and correctness.

Begin your online form submission today by completing the Ohsu Online Radiology Form.