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OFFICE OF RADIOLOGICAL HEALTH. O. Box 2448 7th Floor Richmond, VA 23218 (804) 8648150Specimen Form Radiographic Systems PAGERHF45 01/2021OFFACILITY ID NO.TUBE REGISTRATION NO:NAMEMODELINSPECTORNAMEOKMAKEMACHINEFACILITYNew
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Make sure to provide your personal information accurately on the x-ray form.
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Specify the reason for the x-ray and any relevant medical history.
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Individuals who have been prescribed an x-ray by a healthcare provider in Virginia.
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Patients undergoing certain medical procedures that require x-ray imaging in Virginia.
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X-ray forms in Virginia are documents used to report x-ray exposure information for individuals.
Healthcare facilities and providers who perform x-ray procedures are required to file x-ray forms in Virginia.
X-ray forms in Virginia can be filled out electronically or manually, following the instructions provided by the Virginia Department of Health.
The purpose of x-ray forms in Virginia is to monitor and regulate x-ray exposure levels to ensure safety for patients and healthcare workers.
X-ray forms in Virginia must include details such as patient identification, type of x-ray procedure, exposure levels, date of procedure, and contact information of the facility/provider.
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