X-ray Forms

General Information on .pdf files located on this page:

Please use Adobe Reader to utilize the form features for all forms listed on this page: Registration, Inspection and Postings”.

Browser “lite” versions and “Extensions” of .pdf readers in Chrome, Safari etc. may not have the same full functionality as Adobe Reader.

You will likely find it best to download the forms and open them locally using Adobe Reader.

To set up Adobe Acrobat Reader DC as your default application for .pdf:

  1. Right click the downloaded form file
  2. Select “Open with”
  3. Select “Choose another App”
  4. Select “Adobe Acrobat Reader DC”
  5. Click the “Always use this app to open .pdf files”
  6. Click OK.

Registration

Medical Registration Form: RH-F-2 (01/2020)

Non Medical Registration Form RH-F-3 (01/2020)


Inspection Reporting

X-Ray Machine Inspection Report: RH-F-21 (01/2020)

Radiographic Form: RH-F-22 (01/2020)

Dental Intra-Oral Form: RH-F-23 (01/2020)

PanoramicCBCT Form: RH-F-26 (01/2020)

Veterinary Form: RH-F-25 (01/2020)

Fluoroscopic Radiographic System: RH-F-24 (01/2020)

Computed Tomography Systems: RH-F-28 (01/2020)

Therapeutic Units: RH-F-29 (01/2020)

Bone Density Form: RH-F-36 (01/2020)

Podiatric Form: RH-F-37 (01/2020)

Non-Medical Form: RH-F-33 (01/2020)


Useful Postings

Notice to Employees Form: RH-F-12 (01/2020)

Operator’s List Medical RH-F-31 (01/2020)

Operator’s List Non-Medical RH-F-44 (01/2020)

RADIATION SAFETY PROCEDURES FOR GENERAL RADIOGRAPHY RH-F-40 (01/2020)

RADIATION SAFETY PROCEDURES FOR DENTAL OFFICES RH-F-41 (01/2020)

RADIATION SAFETY PROCEDURES FOR VETERINARY OFFICES RH-F-42 (01/2020)

RADIATION SAFETY PROCEDURES FOR NON-MEDICAL DEVICES RH-F-43 (01/2020)


Office of Radiological Health | 109 Governor Street,  7th Floor | Richmond, VA  23219

Telephone (804) 864-8150 | X-ray Fax: (804) 864-8175