Colorado Department of Public Health and Environment

R-61 Removal of x-ray machine

The Colorado Rules and Regulations Pertaining to Radiation Control (Regulations), 6 CCR 1007-1, Part 2, Section 2.3.4, requires registrants to notify us when any x-ray machine is removed from operation. Use this form to notify us when a radiation machine is sold, traded for a new machine, donated, properly disposed of, or put into storage at the facility.

If you need assistance completing this form please contact the Xray Unit at 303-692-3448 or email Please have your facility number available for reference.
Please complete a separate R-61 form for each x-ray machine you are removing.
Are you closing or selling this facility? (If yes, this will inactivate x-ray account) *
Do you have more x-ray machines at this facility? *

Machine status

What is the status of the x-ray machine? *
Disposal company information
Move information
New location same owner information
New location, different owner information

X-ray machine information

Picture a the blue label with an arrow pointing to the label number.
For the purposes of this form, the Colorado Department of Public Health and Environment accepts your typed name, title and date as an electronic signature equivalent to your valid signature on a paper copy of the form. As such, this electronically completed form subjects the signatory to the same responsibilities as a hand-signed form. Per section 18-8-306, C.R.S., it is a felony to submit false information to a state official.