Get Azrra

Filling out the Azrra application for registering x-ray devices can seem daunting, but with this comprehensive guide, you can navigate the process with confidence. This document provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to fill out the Azrra application effectively.

1. Click the ‘Get Form’ button to access the Azrra application and open it in your preferred online editor.
2. Review the top section of the form where you will need to select the appropriate registration type: registration amendment, registration renewal, or new registration. If you are renewing or amending, you will also need to provide your current registration number.
3. In the next segment, enter your business name (Doing Business As) if it differs from the applicant name, followed by the physical address where x-ray devices are utilized, including the street address, suite number, city, state, and zip code.
4. Complete the mailing address section. If it is the same as the physical address, check the appropriate box. Otherwise, provide the full mailing address details.
5. Fill out the billing address, checking the corresponding box if it is the same as the physical or mailing address.
6. Provide the contact person's details, including their name, title, phone number, fax number, and email address.
7. Select the type of x-ray facility from the options available: chiropractic, dental, educational, hospital, podiatry, veterinary, industrial, medical, mammography, or other. If selecting 'other,' describe the facility type.
8. Indicate the legal structure of your application. Choose one from the options provided and ensure to attach the required documents, such as a driver’s license and social security card if applicable.
9. If necessary, submit a list of names and addresses of individuals or legal entities associated with the partnership, including the percentage ownership held by each.
10. Review all filled sections for accuracy before signing the application electronically or by hand. Ensure to submit your application with any supplemental forms via mail, fax, or email.
11. Finally, once your application is complete, save your changes, and proceed to either download, print, or share the form as needed.

Start completing your documents online today for a streamlined registration process.