Program Activities

Radiological Health Program

3 Capitol Hill, Room 206
Providence, RI 02908
Office: 401-222-2566 (8:30-4:30 M-F)
FAX: 401-222-5901
24/7: 401-272-5952
RI Relay 711

Radiological Health Program

MASTER LIST OF RHODE ISLAND RADIATION FORMS [as of 30 April 2008]
FORM	TITLE	LAST REVISION	STATUS
GEN-1	Registration Certificate – Use of Depleted Uranium Under General License	April 2008	Replaces undated (ca 1980) Never used to-date
GEN-3	Registration Certificate – In-Vitro Testing With Radioactive Material Under General License	Aug 2005	Replaces undated (ca 1980) version
GEN-4	Registration of Devices Possessed Under the General License Issued in Section C.4.2(b) of the Rules and Regulations for the Control Of Radiation	Sept 2007	Replaces Jan 2005 with changes in fees
GEN-4A	Agency Form GEN-4 Continuation Sheet – New Devices	Jan 2005	Replaces distributed final draft dated November 2004
GEN-4B	Agency Form GEN-4 Continuation Sheet – Not In Possession of Device	Jan 2005	Replaces distributed final draft dated November 2004
GEN-4 Series Instructions	Instructions For Completing Agency Forms GEN-4, GEN-4A And GEN-4B	Sept 2007	Replaces Jan 2005 with changes in fees
MAT-1	Application for Radioactive Materials License	Dec 2001	Replaced Jan 2000 and undated (ca 1980) versions
MAT-2	Application for Radioactive Materials License - Medical	Apr 2005	Replaced Feb 2003, Dec 2001, Jan 2000 & Dec 1994 versions
MAT-2A Series	Training and Experience and Preceptor Attestation (6 forms; each specific to ANP, AMP, RSO, AUS, AUT, AUD)	Sep 2007	Replaced MAT-2A version dated Apr 2004
MAT-2A Series Guidance	Instructions For Completing Each Form in MAT-2A Series	Sep 2007	New with introduction of MAT-2A Series
MAT-7	Certificate of Disposition of Materials	Jan 2001	Replaced Aug 1981 version
MAT-9	Report of Proposed Activities in Rhode Island Except for Areas Under Exclusive Federal Jurisdiction [and Instruction Sheet]	Dec 2001
RCA-1	Notice To Employees	Jan 1994	Replaced earlier (ca 1980) version
RCA-2	Cumulative Occupational Exposure History	Jan 1994	Replaced earlier (ca 1980) version
RCA-3	Occupational Exposure Record For A Monitoring Period	Jan 1994	Replaced earlier (ca 1980) version
RCA-R1	Diagnostic X-ray Equipment Facility	August 2009	Replaced Mar 2004 version
RCA-R2	Cabinet X-ray Facility	August 2009	Replaced Mar 2004 version
RCA-R3	Analytical X-ray Facility	August 2009	Replaced Mar 2004 version
RCA-R4	X-ray Equipment Services	August 2009	Replaced Mar 2004 version
RCA-R5	Radiation Physics Services	August 2009	Replaced Nov 2004 version
RCA-R6	Industrial Radiography Facility	August 2009	Replaced Mar 2004 version
RCA-R7	Particle Accelerator Facility	August 2009	Replaced Mar 2004 version
RCA-R8	Therapeutic Radiation Machine Facility	August 2009	Replaced RCA-R8 (Mar 2004) and RCA-R7 (Apr 1978)
TAN-	Application For Registration of Tanning Facilities	June 2007	Replaced TAN (Feb 2006)

Our Mission

The primary mission of the Program is to assure the safe use of radioactive materials, x-ray equipment, and tanning equipment in order to protect the Rhode Island public and workers from excessive exposure to ionizing and non-ionizing radiation through a licensing and targeted enforcement program.

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