Forms not submitted in 30 days will be deleted

  1. 1New Facility
  2. 2Machine Inventory
  3. 3Review
  4. 4Sign & Submit

Use this form only when both of the following conditions are met:

  1. Your facility, business, or practice possesses one or more radiation machines; and
  2. Your facility, business, or practice does not already have a registration number issued by the
    California Department of Public Health, Radiologic Health Branch (CDPH-RHB)

Facility Information

Facility Contact Information

Registrant Information

Physical Address (cannot be P.O. Box)

Mailing Address