R-68 X-ray Qualified Expert

This form is an application for registration as a Colorado Qualified Expert who designs or evaluates shielding of x-ray producing machines. The registration is for a one year period. Renewals must be received 30 days prior to the expiration date. Please refer to 6 CCR 1007-1 Colorado Rules and Regulations Pertaining to Radiation Control Part 2, Appendices 2-B and 2-C for additional information. (QE registration is included in Registered Medical Physicist (RMP) registrations and does not require a separate application from RMP registration). Please indicate if this is a new application or a renewal.

If this is a new registration, we will email an invoice after your application is approved.

If this is a renewal, you should have received an invoice in the mail sixty days prior to your expiration date. *

Applicant information

Preferred contact method *

Qualifications and experience

Education *

Professional information

Professional Certification. Select all that apply *

Qualified Expert category *
Do you want your registration to be listed on the CDPHE website?
Registration verification listed online - link will open in a new window *
Qualified expert's geographic coverage *
Instrumentation Calibration: Applicant will perform all radiation exposure surveys with instruments that are in compliance with 6 CCR 1007-1, Part, maintained in good working order, and calibrated at least every two (2) years, or in accordance with the manufacturer's recommendation, whichever is more frequent, or after any repair that could affect the calibration of the instrument. *

Certification and signature

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