Get Oregon X-ray Control Panel Registration Application - Public Health Oregon
How it works
-
Open form follow the instructions
-
Easily sign the form with your finger
-
Send filled & signed form or save
How to fill out the Oregon X-ray Control Panel Registration Application - Public Health Oregon online
This guide provides a step-by-step approach to completing the Oregon X-ray Control Panel Registration Application. It is designed to ensure that you fill out the form accurately and efficiently, facilitating the registration of your X-ray control panel.
Follow the steps to successfully complete the application.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Begin by entering the vendor information. Fill in the name of the vendor or previous owner, their valid license number, and their contact details including address, email, and phone number.
- Next, provide the registrant information. Include the owner name, facility name, physical address, and both phone and fax numbers at the physical location. Make sure to provide the mailing address and the owner's email address as well.
- Indicate whether you currently have any X-ray control panels registered with the office. If yes, input your current Facility ID number, which can be found on the upper left corner of your validation certificate.
- If this is your first X-ray machine in Oregon, check the appropriate option and proceed to the next section.
- Enter the machine information. Fill in the manufacturer, model, control panel serial number, maximum kVp, mA, and the number of tubes. Additionally, include the Health Division RAD number if applicable.
- Specify the date you acquired the machine or brought it into Oregon along with selecting your facility type and the style of the machine.
- Indicate the machine room location and select all applicable device types for your machine.
- If replacing an existing control panel, provide the control panel serial number and State ID number for the panel being replaced.
- Complete the application by adding the contact information for the new owner, if applicable, followed by the registrant/owner's signature and date.
- Once you have filled out the form completely and accurately, proceed to save your changes. You can also choose to download, print, or share the form as needed.
Complete your documents online today to ensure your X-ray control panel is registered promptly.
To contact the Oregon Health Authority, you can visit their official website where you can find phone numbers and email addresses for various departments. They provide resources for inquiries about health services, including the Oregon X-ray Control Panel Registration Application - Public Health Oregon. It’s advisable to gather relevant information before reaching out to make your communication efficient.
Industry-leading security and compliance
-
In businnes since 199725+ years providing professional legal documents.
-
Accredited businessGuarantees that a business meets BBB accreditation standards in the US and Canada.
-
Secured by BraintreeValidated Level 1 PCI DSS compliant payment gateway that accepts most major credit and debit card brands from across the globe.