Radiation Source Service Notification

About this form

This form must be submitted to the Health Protection Service (HPS) within 14 days of any installation, service or repair of a regulated radiation source.

A calibration report may be attached to this form.

Following a tube change a full service report must be submitted to HPS, indicating that the equipment has been tested and meets the relevant Australian Standards.Provided this report has been submitted to HPS, the equipment can then go back into clinical operation.

Your personal information

Access Canberra uses this form to collect information which is necessary to allow the ACT Government to provide services to you. Personal Information may be used or disclosed in accordance with the Information Privacy Act 2014.

For details on the collection of personal information in this form please refer to the Access Canberra Information Collection Notice. If you have questions about how your information will be handled please see the Access Canberra Privacy Policy and the ACT Health Privacy Notice or contact us.