Forms & Documents
Click on the links below to download the form you need:
Radiation Safety Program
Document put out by the Colorado Department of Public Health and Environment (CDPHE) that reviews everything you need to know about creating and maintaining a proper radiation safety program.
Adobe Acrobat document [273 KB]
Document from the CDPHE that describes your responsibilities as a company that owns x-ray equipment in the State of Colorado.
Adobe Acrobat document [23.6 KB]
Registering a New Office, Changing Ownership of an Office, Registering a New X-ray Machine
If you are opening a new office, purchasing an existing practice or have a new x-ray machine, you need to fill out this document and send it in to the Colorado Department of Public Health and Environment (CDPHE).
R-4 Form.pdf R-4a Registration of Radiation Machines
Adobe Acrobat document [195 KB] Adobe Acrobat document [258 KB]
R-4 Online Registration Form The State would prefer you to use this form to upload your information digitally.
Request for a Dosimetry Monitoring Waiver
Form used to ask the CDPHE if you can stop radiation monitoring and to issue a waiver from having to use dosimeter badges. You MUST have 6 months of current data to make this request.
Adobe Acrobat document [320 KB]
Getting Rid of an Old X-ray Machine
Form you will need to send to the CDPHE if you are getting rid of an x-ray machine or placing it in storage. You will need the workorder to upload or signature of the certified technician who disables, disassembles or removes the machine.
Adobe Acrobat document [124 KB]
R-61 On-line Form The State would prefer you to use this form to upload your information digitally.