Get Az Arra-4x 2017-2025

Completing the AZ ARRA-4X form is an essential step in registering a diagnostic x-ray source of radiation. This guide provides clear, step-by-step instructions to help users navigate the online form easily and accurately.

Follow the steps to successfully complete the AZ ARRA-4X form.

1. Press the ‘Get Form’ button to access the form and open it in your document editor.
2. Begin filling out the form by entering your facility name, street address, city, and zip code in the designated fields.
3. If you are a current registrant, provide your registration number in the appropriate field. If you are a new applicant, indicate this accordingly.
4. Provide your name, title, and phone number. Additionally, include your email address and the current date.
5. Select the type of x-ray machine you are registering by checking the applicable box next to the machine type section. This may include various options such as intra-oral or CT scanner.
6. Specify the machine subtype as either stationary, mobile, or portable by selecting the appropriate option.
7. Complete the equipment information section by detailing the manufacturer name, model name, number of tubes, and whether the unit is new, a replacement, or handheld.
8. If applicable, provide information about the unit being replaced or removed, including the make and model name and the details of the transfer.
9. Follow the shielding information instructions by attaching a scale drawing of the facility, construction materials, and calculations needed for compliance.
10. Include specific instructions for equipment operators, adhering to the regulatory requirements and suggestions outlined.
11. Ensure you are maintaining all necessary records as required, including maximum technique factors and filtration records.
12. After completing the form, review all information for accuracy before saving your changes. You may choose to download, print, or share the form as needed.

Complete the AZ ARRA-4X form online today to ensure compliance and effective registration.