Radioactive materials forms and applications
Obtain a copy of a radioactive materials form in Microsoft Word format.
License forms and instructions
- Application form for all other radioactive materials licensing.
- Application for the use of radioactive materials for industrial radiographic operations.
- R-12 (7C) application for medical use of radioactive materials.
- R-11 (7C) instructions for application for license for the medical use of radioactive material.
- 313A (AUS) request for authorized user (physician) for therapeutic uses of sources/devices (7.42, 7.48 uses). (Temporarily unavailable while being updated.)
- 313A (RSO) request for medical radiation safety officer authorization. (Temporarily unavailable while being updated.)
- 313A (ANP) request for authorized nuclear pharmacist authorization. (Temporarily unavailable while being updated.)
- Instructions for Patients Treated With Iodine-131.
- Instructions for Patients Treated With Radiopharmaceuticals or Implants.
- OR-RH 12-3.N application for persons providing services for other licensees.
- Portable nuclear gauge license application.
- OR-RH-12.PRV application for a provisional license authorizing temporary possession of radioactive material pending disposal.
- DOT-SP 10656 Shipment Approval Form
- Downloaded blank form from the Conference of Radiation Control Program Directors (CRCPD) Transportation, complete and submit by email to cdphe.hmdSpecialPermit@state.co.us.
- Reciprocity notification Form.
- Request for Termination of a Radioactive Materials License.
- R-27 Certificate - In-vitro Testing with Radioactive Materials Under a General License.
Radioactive materials inspection form
- Portable nuclear gauge public dose calculations.
- OR-RH 15 notice to employees form-legal size.
- Standards for protection against radiation, notices, instructions and reports to workers, inspections, employee protection.
- OR-RH 16 Cumulative Occupational Exposure History.
- OR-RH 17 Occupational Exposure Record for a Monitoring Period.
- National Source Tracking System: NRC Form 748.