Istration – JR B. ADDRESS INFORMATION for the physical location of the radiation machine(s) Name of Facility posted at this location Doctor or other responsible party at this location Street Address of Facility (no PO Boxes, etc.) Facility Telephone Number City, State and Zip code Facility FAX Number (optional) County E-mail address (optional) C. BILLING/MAILING INFORMATION if different from address information Billing/Mailing Name Contact person for billing purposes Billing/Maili.

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How to fill out the FL DH 1107 online

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.

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Questions & Answers

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What are the legal requirements for the practice of radiography in Florida?

ing to s. 468.304, F.S., all applicants desiring certification must: submit a completed application along with the required fee; be at least 18 years of age at the time of application; be of good moral character; and have completed an approved educational program (school).

Florida has been licensing radiography practitioners since 1978. There are several types and levels of licensing. Radiographers have completed two-year educational programs and also passed a national exam. This is the level of practice that people are usually referring to when they use the term radiology technologist.

Typical requirements include graduating from an accredited program and passing a certification exam administered by the state or from the American Registry of Radiologic Technologists. Certification is available in each of the radiographic specialties, such as mammography, computed tomography or bone densitometry.

(a) Each person who installs or offers to radiation machines or furnishes or offers to furnish radiation machine servicing or services in Florida shall apply to the Department to register such services before furnishing or offering to furnish such services.

As of Apr 23, 2024, the average hourly pay for a Radiology Technician in Florida is $31.44 an hour. While ZipRecruiter is seeing salaries as high as $55.69 and as low as $11.86, the majority of Radiology Technician salaries currently range between $23.51 (25th percentile) to $43.12 (75th percentile) in Florida.

Individuals with a criminal history may not be eligible for admission to health sciences programs. Current laws generally permit a licensing board or agency to deny a license and/or certification in radiography if the applicant has been convicted of a felony or misdemeanor.

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