Forms

Radioactive Material

Document	Description
Form RM	Application for a Radioactive Materials License
Form RM-HU (AUD)	Preceptor Form for Physicians Wishing to be Authorized for Use of Unsealed Radioactive Materials and Diagnostic Sealed Sources for which a Written Directive is Not Required
Form RM-HU (AUT)	Preceptor Form for Physicians Wishing to be Authorized for Use of Unsealed Radioactive Materials for which a Written Directive is Required
Form RM-HU (AUS)	Preceptor Form for Physicians Wishing to be Authorized for Use of Sealed Source Radioactive Materials for which a Written Directive is Required
Form RM-HU (RSO)	Preceptor Form for Individuals Wishing to be Authorized for Medical Use Radiation Safety Officer
Form RM-HU (AMP)	Preceptor Form for Individuals Wishing to be Authorized as Therapeutic Medical Physicists
Form RM-HU (ANP)	Preceptor Form for Individuals Wishing to be Authorized as Nuclear Pharmacists
Form RH 313R	Radioactive Material Application Addendum for Industrial Radiography (Corporate Structure)
Form SM	Application for a Source Material License
Form DRM	Disposition of Radioactive Material (Documentation of Proper Transfer or Disposal)
Form GL	Registration of General License Devices
Form RR	Request to Work In Alabama Under Reciprocity
View Schedule	Fee Schedule for Radioactive Material Licensees after August 14, 2012
Form S	Medical Misadministration Report
Form Small Entity	Certification of Small Entity Status for Annual Fees
Form Y	Cumulative Occupational Exposure History
Form Z	Occupational Exposure Record for a Monitoring Period

Machine Registrations

Document	Description
View App	Application for Registration for Sources of Radiation (For Medical X-Ray Tubes with Energies <0.9 MeV)
Form PA-2	Application for Notice of Registration (To Register Accelerators and Cyclotrons with Energies >0.9 MeV)
Form NMX	Application for Non-Medical X-Ray Registration (Industrial X-Ray Units)
View Form	Registration of Radiation Services For Medical X-Ray Equipment
View Form	Registration of Radiation Services For Non-Medical X-Ray Equipment
Form PA-NRS	Application to Register as a Servicer of Particle Accelerators (For Companies)
Form PA-NRS-1	Application to Register as a Servicer of Particle Accelerators (Supplemental Form for Individuals)
View Form	Radiation Safety Training Certificate for Servicers of X-Ray Equipment
View Form	Request for Handheld Dental X-Ray Exemption
View Form	X-Ray Screening Request

Machine Assembly

Document	Description
View Form	Report of Assembly of Non-Certified X-Ray Systems - i.e. those not reported on Federal Form FD2579

Industrial Radiography Certification

Document	Description
View Schedule	2013 Exam Schedule and General Information - Radiographer Examination Schedule
View App	Application for Industrial Radiographer Examination - Radiographer Cert Application
View Form	Request for Disability Accommodation for Industrial Radiography Examination - Radiography Disability
View Form	Procedure to Replace a Lost or Misplaced Radiographer Certification ID Card - Radiographer Card Replace
View Form	Procedure to Upgrade Radiographer Certification ID Card from Single Purpose (Example:  X-Ray Only) to Dual Purpose (Both X-Ray and RAM) - Radiographer Second Card
View Form	Industrial Radiographer On-The-Job Training (OJT) Form - Radiographer OJT Card
View Form	Industrial Radiographer Qualification Form - Radiographer Qualifications

DOT Exemptions

Document	Description
View Form	Instructions for radiation found in scrap metal
View Form	Exemption Form scrap metal
View Form	Marking scrap metal
View Form	Instructions for radiation found in waste
View Form	Exemption Form waste
View Form	Marking waste

General

Document	Description
View Form	Radiological Emergency Assistance Form
Form X	Notice to Employees
Form 100	Notice of Where Copies of Documents May be Found