Get Radiation Safety Licensing Branch Additional Information For ... - Dshs State Tx

This guide provides clear and detailed instructions on how to complete the Radiation Safety Licensing Branch Additional Information form online. Following these steps will help ensure that your registration request for an accelerator is submitted correctly and efficiently.

Follow the steps to complete your online application.

1. Click ‘Get Form’ button to access the form and open it in the designated editor.
2. Begin by filling in the facility name and room name at the top of the form. This is essential for identifying your specific registration request.
3. Enter the workload in Rm2 per week, as this defines the degree of use for the x-ray unit. Be sure to provide accurate numbers for effective evaluation.
4. Specify the voltage of the accelerator in mega-volts (MV) to assist in the regulatory assessment.
5. Provide the registration number if applicable. This helps in linking your submission with existing records.
6. For each barrier, complete the details by entering the barrier name and circling whether it is a primary or secondary barrier. Indicate if it is controlled or uncontrolled as well.
7. Fill in the use factor and occupancy factor for each barrier. These values are crucial for calculating the necessary shielding.
8. Input the distances from the isocenter to the primary and secondary barriers in meters. This information is vital for accurate shielding calculations.
9. Specify the thickness of the barrier in centimeters and choose the type of barrier material from the provided options. If other materials are used, specify them and include their tenth-value layer thickness.
10. Repeat steps 6 to 9 for any additional barriers that may be present. Ensure all barriers are correctly documented.
11. Include any required diagrams, shielding calculations, operating procedures, and the supervising radiation oncologist's credentials as necessary.
12. After completing all sections of the form, review the information for accuracy. Save changes, download, print, or share the form as needed.

Complete your documents online to ensure compliance and expedite the licensing process.