RHS 8-4 (For Office Use Only) Registration No. Date Registered STATE OF TENNESSEE DEPARTMENT OF ENVIRONMENT AND CONSERVATION DIVISION OF RADIOLOGICAL HEALTH 3RD FLOOR, L & C ANNEX, 401 CHURCH.
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How to fill out the Rhs 8 4 Form online
Filling out the Rhs 8 4 form is an important step for the registration of x-ray producing equipment. This guide provides clear, step-by-step instructions to help users complete the form accurately and efficiently online.
Follow the steps to fill out the Rhs 8 4 Form effectively.
- Click ‘Get Form’ button to obtain the form and open it in your chosen editor.
- In section I, fill in the details of the possessor, including their name and full address, consisting of street number, city, county, and zip code.
- Complete section II by entering the owner's name, which could be a person, corporation, or agency, along with their address in the same format as above.
- In section III, provide the name of the Radiation Safety Officer or the person responsible for the x-ray equipment and include their telephone number.
- For section IV, state the medical specialty of the possessor, indicating the specific field of practice.
- Proceed to section V to list each x-ray producing equipment, specifying for each tubehead: the room number, tube number, classification, equipment information, type (fixed, mobile, or portable), and maximum kVp.
- At the bottom of the form, certify the accuracy of the information by signing and dating it. Ensure the signature of the possessor is included.
- Once you have filled out the form, review all sections for accuracy, then save your changes, and you may opt to download, print, or share the completed form.
Complete your Rhs 8 4 Form online today for seamless registration.
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