Applications and Forms - Radioactive Materials Licensing


Radioactive Materials Licenses

Radioactive Materials Applications and Forms
Document Number Title
CI-40 General License Acknowledgement Self-Evaluation Form (PDF, 1.49MB)
RC 251-2 General License Acknowledgement of Devices Containing Radioactive Material (PDF, 1.3MB)
RC 252-1 Business Information Form - License (PDF, 256KB)
RC 252-2 Radioactive Material License (PDF, 66KB)
RC 252-4Certificate of Disposition (PDF, 206KB)
313A(RSO)Radiation Safety Officer (and Associate Radiation Safety Officer)
313A(AUD)Authorized Users for (1)Uptake, Dilution, and Excretion Studies (2)Imaging and Localization Studies (3)Sealed Sources for Diagnosis
313A(AUT)Use of Unsealed Radioactive Material for which a Written Directive is Required (Including I-131)
313A(AMP)Authorized Medical Physicist or Ophthalmic Physicist
313A(ANP)Authorized Nuclear Pharmacist
313A(AUS)Manual Brachytherapy, Ophthalmic Use of Strontium-90, Remote Afterloaders, Teletherapy Units, or Gamma Stereotactic Radiosurgery Units
RC 257-1
Application for A Low Level Radioactive Waste Shipper Registration (PDF, 251KB)
RC 257-2
Application for Low Level Radioactive Waste Transporter Registration (PDF, 230KB)

Notice to Employees

Notice to Employees
Document Number Title
RC 203-1 Notice to Employees (PDF, 10KB)
RC 232-1 Notice to Employees (Dentists Only) (PDF, 9KB)
RC 233-2 Notice to Employees (Vets Only) (PDF, 64KB)

Training and Qualification

Training and Qualification Documents
Document Number Title
RC 255-C Accepted Radiation Safety Training Courses (PDF, 66KB)

Licensing Reciprocity

Licensing Reciprocity Forms
Document Number Title
RC 252-3 Notice of Intent to Work in Texas Under Reciprocity (PDF, 306KB)
Please review the “Sensitive Information” notice on the form.
Fillable form version of the RC 252-3 (PDF, 320KB)
RC 252-5RAM Reciprocity Application (PDF, 158KB)

Last updated April 7, 2022