General Medical Forms & Guidance Documents

(Interactive forms* must be opened with Internet Exployer or downloaded & opened with Adobe Reader or Acrobat.)

• *RH 2000 (PDF-Interactive) -  Medical RML Application        
• HDR Guide (PDF) for authorization to use high dose remote afterloaders by medical licensees.
• Part 35 Questions and Answers.  Some of the questions and answers were developed using a version or sections of Part 35 that are not adopted by the State of California and may not apply.
• Specialty Board(s) Certification recognized by the U.S. Nuclear Regulatory Commission under 10 CFR Part 35
• NUREG-1556 Volume 9  (PDF)
  
• Supplement to NUREG-1556, Vol 9. (PDF)
  
•    NUREG-1556 Volume 11 
• Reciprocity Guidance (PDF: 110 KB). Guidance for Licencees Applying for Reciprocal Recognition of Radioactive Materials Licenses
  

Part 35.1000 Guidance.

• Best Vascular, Inc. Beta-Cath IVB System
• GliaSite
• Iodine-125 & Palladium-103 Low Dose Brachytherapy
• Leksell Gamma Knife Perfexion (PDF)
• NeoVista Inc. Epi-Rad Ophthalmic System (PDF)
• Nucletron seedSelectron System, Isotron Brachytherapy Sources and Nucletron FIRST System (PDF)
• Microsphere Brachytherapy (PDF)
  

Authorized Users:

• Video Guide instructions for Form RH 313A (AU) for completing the RH 313A (AU) Training and Experience Form.
• *Form RH 313A (AU) (PDF-interactive) to apply for authorized user status under either 35.100, 35.200, 35.300, 35.400, 35.500 or 35.600. 
• For physicians who wish to apply for 35.1000 authorization, refer to the applicable RHB or NRC guidance and submit the required specific training and experience documentation separately.  If  requirements under 35.190, 35.290, 35.390, 35.490, 35.590 or 35.690 are required, you may use *Form RH 313A (AU)(PDF-interactive) to document that portion of the training and experience.

Radiation Safety Officers (RSO):

• Video Guide instructions for completing Form RH 313A (RSO).
• *Form RH 313A (RSO)(PDF-interactive). 
• RSO: Duties & Responsibilities and Delegation of Authority (PDF).

Authorized Medical Physicists (AMP): 

• Video Guide instructions for completing Form RH313A (AMP)(PDF).
• *Form RH 313A (AMP)(PDF-interactive). 

Authorized Nuclear Pharmacists (ANP):

• Video Guide instructions for completing Form RH 313A (ANP).
• *Form RH 313A (ANP) (PDF-interactive).​ 

Nuclear Medicine Technologists (NMT):

• NMT - Administration of Radiopharmaceuticals (PDF)

Licensing Forms ​​

• CDPH 8219 (PDF) - Industrial Radiorapher Trainer Form.
• CDPH 8240 (PDF) - GLD Registration Form.
• RH 2050 (PDF) - RML Application (Non-medical).
• RH 2050A (PDF) - Statement of Training and Experience (Non-medical).
• CDPH 5314 Notice (PDF) about terminating a License.
• CDPH 5314 (PDF) - Certificate of Disposition of Materials.

Guides & Information

• Guidance for Decay in Storage Method of Waste Disposal (PDF)
• Guidance for Termination and Decommission for Sealed Source Use only (PDF)
  
• Industrial Radiography (PDF).  Information for Industrial Radiography licensees.
  
• Irradiators-Large (PDF).  Information for large irradiator licensees.
• Irradiators-Small (PDF).  Information for small irradiator licensees.
• Krypton-85 (PDF).  Guidance for Krypton-85 leak test systems.
  

• Ownership Change - Sample (DOCX). Sample letter for requesting a change of ownership. (Download and save the sample to your computer.  Then open the document from your computer.  If you continue to have difficulty accessing this document, please contact CDPH at RHBGLLicensingInfo@cdph.ca.gov  to request this information in an alternate format.)

• Portable Nuclear Gauge Guidance (PDF).
  
• Reciprocity Guidance (PDF: 110 KB)). Guidance for Licencees Applying for Reciprocal Recognition of Radioactive Materials Licenses.
  
• Research and Development Laboratories (PDF: 244 KB).  Guidance for Research and Development Laboratory licenses.
  
• SSD-Registration Review (PDF). Information on obtaining approval for SSDs.
• Veterinary License Guide (PDF) for completing veterinary applications.
• Well Logging & Tracer Application (PDF). Information on completing applications.
  

Checklists

• Fixed Gauge Application Checklist (PDF)

• Gas Chromatograph Application Checklist (PDF)     
  

• X-ray Fluorescenc Application Checklist (PDF)

Lists

• Delegation of Authority:
• Radiation Safety Officer (RSO) (PDF)
• RSO: Academic (PDF)
• RSO: Medical (PDF)
• RSO: Medical & Academic (PDF)
• RSO: Nuclear Pharmacy (PDF)
• RSO: Manufactures & Distributors; Service Providers; Fixed Gauge users; Irradiator users; Waste Brokers; Leak Testing Device user; Exempt Distributors; Possession incident to Exempt Distribution; Measuring System user.  (PDF)
• Alternate RSO (ARSO) (PDF)
• Duties & Responsibilities:
• RSO
• Academic (PDF)
• Industrial Radiography (PDF)
• Manufactures & Distributors; Service Providers; Fixed Gauge users; Irradiator users; Waste Brokers; Leak Testing Device user; Exempt Distributors; Possession incident to Exempt Distribution; Measuring System user.  (PDF)
• Medical (PDF)
• Medical & Academic (PDF)
• Nuclear Pharmacy (PDF)
• Portable Nuclear Gauge (PDF)
• Research & Development Laboratory (PDF)
• Veterinary (PDF)
• Well-Logging (PDF)
• ARSO
• Industrial Radiography (PDF)
• Portable Nuclear Gauge (PDF)
• Research & Development Laboratory (PDF)
• Veterinary (PDF)
• Well-Logging (PDF)