X-ray Registration Forms

Facilities in Minnesota with ionizing-radiation producing x-ray equipment must be registered with the Minnesota Department of Health, Radiation Control, X-ray Unit. X-ray fees cover the costs of running a statewide registration, compliance and education program, to help assure that the health and safety of the workers and general public are protected. The fees are approved by the legislature and every facility with x-ray equipment is required to pay a fee to support the program. Fees are mandated under Minnesota Statute 144.121.

Facility Registration Information Notice (PDF: 98KB/2pages)

Initial Registration
(new facility or new ownership)

This form should be completed by facilities not currently registered with MDH, facilities currently registered but under new ownership, or a satellite office that has not been registered. New facilities obtaining x-ray equipment must pay fees and certify their facility prior to first use of x-ray equipment.

Additional Registration
(new equipment or replacement at registered facilities)

For facilities that are currently registered with MDH who have additional or replacement equipment. Facilities already registered with MDH, with new or replacement equipment, must notify MDH within 30 days and prior to first use of the equipment..

X-ray Machine Equipment Transfer
(transfer equipment between facilities under same ownership)

For facilities that would like to transfer x-ray equipment from one of their registered locations to another. Equipment must be currently registered within the last 6 months. If registration is not current, please fill out the Additional Registration form and pay applicable fees.

Change in Facility Information

For facilities that have a change in facility information: equipment changes, facility name, address change, administrator or RSO change, Tax Id changes, etc., fill out the form below.

Updated Friday, October 31, 2014 at 02:11PM