Get Mde Rx 22 - Maryland Department Of The Environment - Mde State Md

Filling out the MDE RX 22 form is essential for the Maryland Department of the Environment's Radiological Health Program. This guide provides step-by-step instructions to help users easily complete the form online.

Follow the steps to accurately complete the MDE RX 22 form.

1. Click ‘Get Form’ button to obtain the form and open it for completion in the editor.
2. Begin by providing general information about the facility. Include the facility location, the name of the person conducting the survey, and their contact information including address and telephone number.
3. Fill in the facility information section. Enter the date prepared and registration number in the respective fields.
4. Attach a drawing indicating required details such as tube and cassette locations, primary beam directions, control location, and other specifications outlined in the section.
5. Provide calculated weekly workloads for different unit types. Input the mA min/week for each listed category, ensuring to fill in the specific details for therapy or other units as needed.
6. Indicate the method used for measurements by circling the appropriate choice: Film badge, TLD, or Ion Chamber. If using an ion chamber, fill in the manufacturer and model number. For film badge or TLD, enter the service provider.
7. Complete the parameters used for setting the x-ray machine, including KVp, ma, and timer values. Please use the maximum settings from the technical chart for each relevant projection.
8. Describe the phantom material used for the measurements, along with its dimensions.
9. Check the type of unit being surveyed and identify the room. Provide specific room identification information.
10. Complete the data table with locations, measurements, use, occupancy type, and certification of the facility design by the representative. This includes signing and printing the name and date.
11. After completing all sections, review the form for accuracy. You can then save the changes, download a copy for your records, print, or share the completed form as needed.

Complete your MDE RX 22 form online today for a seamless radiological health compliance process.