Get Fl Dh 1107 2015-2025

The FL DH 1107 form is essential for registering a radiation machine facility in Florida. This guide will walk you through each component of the form, providing clear, detailed instructions to help you complete it accurately online.

Follow the steps to complete the FL DH 1107 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In section A, indicate whether you are registering a new facility or making changes to an existing registration by marking the appropriate checkbox.
3. In section B, fill out the address information for the physical location of the radiation machine(s). Include the name of the facility, the responsible person's name, street address, telephone number, city, state, zip code, and optional fax number and email address.
4. If the billing or mailing address is different from the physical address, complete section C with the necessary billing details, including name, contact person, address, telephone number, and optional fax number.
5. In section D, select the appropriate category for your facility registration. If applicable, provide details for each category by checking the corresponding box.
6. Section E requires information about each radiation machine. Fill out the manufacturer’s name, model name, control serial number, installation date, room location, and indicate if the machine is new, present, removed, inoperable, or meets specified standards.
7. Use section F to provide any additional comments or information that may be relevant to your registration.
8. In section G, the signer must acknowledge various statements regarding the application. Ensure all statements are read and understood before signing, printing the name, indicating the title or position, and adding the date.
9. After completing all sections, save changes, download the form for your records, print a copy, or share it as necessary.

Complete your documents online to streamline the process and ensure compliance.