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Get Example Form - Dshs State Tx
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How to fill out the EXAMPLE FORM - Dshs State Tx online
Filling out the EXAMPLE FORM - Dshs State Tx is essential for assessing equipment performance in fluoroscopic units. This guide provides clear step-by-step instructions to ensure you complete the form accurately and efficiently.
Follow the steps to complete the form online.
- Click ‘Get Form’ button to obtain the form and open it for editing.
- Enter the facility name in the designated field at the top of the form. Make sure the name is accurate as it is critical for official records.
- Fill in the registration number, followed by the date of the equipment performance evaluation.
- Indicate the survey instrument used by selecting the appropriate box for exposed sensor/detector or enclosed sensor/detector.
- Provide the calibration date of the equipment in the designated field to ensure compliance with regulations.
- For the X-ray unit identification section, input the manufacturer, model number, and serial number in the respective fields.
- Document the minimum x-ray field size at maximum source to image distance (SID) by calculating and entering the dimensions, then mark pass, fail, or not applicable.
- For the x-ray field at the image receptor, measure or calculate the field size and enter the misalignment, marking the appropriate pass or fail option.
- Fill in the spot film device details, including the size and misalignment, while following the same pass or fail documentation.
- Ensure center alignment is completed by noting any misalignment measurements and indicating whether it passes or fails.
- Input exposure rate limits according to the regulations specified for the equipment’s manufacture date.
- Lastly, have a licensed medical physicist perform the required evaluations, sign, and date the form, ensuring all fields are completed.
- Review all entries for accuracy, then save changes, and you may opt to download, print, or share the form as needed.
Complete your document filing process online today to ensure compliance and operational efficiency.
If Texas DSHS is reaching out to you, it may be to discuss your health services or to follow up on an application you submitted. They might also be providing important updates regarding public health issues in your area. To ensure you understand their communication, the EXAMPLE FORM - Dshs State Tx can help clarify any required actions or information they need from you.
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