Get Az Arra-4x 2014

The AZ ARRA-4X is an essential form for registering a diagnostic x-ray source of radiation for dental, medical, podiatric, or veterinary applications. This guide will provide you with step-by-step instructions to successfully complete the form online.

Follow the steps to fill out the AZ ARRA-4X form accurately.

1. Press the ‘Get Form’ button to access the document and open it in your preferred online editor.
2. Begin filling out the form by entering the facility name, street address, city, and zip code where the diagnostic x-ray unit will be located.
3. If currently registered, provide the registration number for your facility.
4. Indicate the date you are completing the form by selecting or entering the appropriate date.
5. Fill out your name and title in the designated fields, ensuring that all information is accurate.
6. Select the type of diagnostic x-ray machine you are applying to register by checking the applicable option, e.g., radiographic or mammographic.
7. Specify the machine subtype by indicating whether it is stationary, mobile, portable, or handheld.
8. Provide details about the equipment, including the manufacturer's name, model name, number of tubes, and the specific location of the unit.
9. Indicate whether this unit is replacing a registered x-ray unit in your facility and provide additional details if applicable.
10. Attach the necessary scale drawing of the facility along with your calculations for shielding compliance as required.
11. Include specific instructions for equipment operators along with any restrictions.
12. Familiarize yourself with the requirements under AZ Administrative Code to ensure all necessary records and correspondences are maintained.
13. Sign the form electronically where indicated to affirm that all information provided is accurate.
14. Once all fields are completed, save your changes, then download or print the form for your records.

Complete your documents online today to ensure a smooth registration process.