Get Dh Form 1107

The Dh Form 1107 is essential for the registration of radiation machine facilities. This guide provides clear and instructive steps to help you successfully complete the form online, regardless of your experience with similar documents.

Follow the steps to easily complete the Dh Form 1107 online.

1. Click ‘Get Form’ button to access the Dh Form 1107 and open it in your document preparation interface.
2. Begin by selecting the appropriate option under section A to indicate whether this is a new facility registration or a change to an existing registration. Make sure to clearly mark your choice.
3. In section B, provide the complete address information of the facility where the radiation machine(s) will be located. Include the name of the facility, responsible party, street address (avoid using PO Boxes), contact numbers, and relevant city, state, and zip code.
4. If the billing or mailing information differs from the facility address, fill out section C with the required billing name, contact person, billing address, and associated phone numbers.
5. For new registrants, proceed to section D and identify the facility category that corresponds to your registration. If multiple categories apply, remember that a separate form must be completed for each.
6. Continue to section E to provide details for each radiation machine. Include the manufacturer's name, model name, control serial number, installation date, and the room where it is located. Check the appropriate boxes regarding the machine’s status.
7. In section F, utilize the comments area to include any additional information that may be relevant to your application.
8. Finally, complete section G by signing the form, including your title or position, printed name, and date to acknowledge all statements made in your application.
9. Review all entries for accuracy. Once you are satisfied, save your changes, and you can either download, print, or share the completed form as needed.

Start filling out the Dh Form 1107 online today to ensure compliance with regulations.