Radiation – Forms and Links
Application Forms for Radiation Facility/Service License:
Radiation Facility License Application – License to acquire, install and use electronic sources of ionizing radiation.
Radiation Service License Application – License to provide services for sources of ionizing radiation (including servicing, selling, leasing and providing health/medical physics services).
Radiation License Information Sheet – Informational guide for licensing requirements.
Radiation Facility/Service License Amendment Form – Request form for making amendments to existing licenses.
Shielding Evaluations & Area Radiation Surveys – Area survey and shielding evaluation requirements informational sheet.
Application Forms for Radiologic Technology Board (RTB) Licensure:
RTB License Application Form (New Licensee) – License application for new Radiographers, Radiation Therapists, and Nuclear Medicine Technologists.
RTB License Application Guide – Informational guide for licensing requirements.
RTB License Renewal Form – License renewal form for current Hawaii-licensed Radiographers, Radiation Therapists, and Nuclear Medicine Technologists.
RTB License Re-application Form – License re-application form for recently (within the past year) defunct Hawaii licensees.
RTB License Re-application Guide – Informational guide for re-licensing requirements.
Rules and Regulations for Radiation:
Title 21, Code of Federal Regulations, Part 1020, Radiation-Emitting Electronic Systems
Title 21, Code of Federal Regulations, Part 900, Mammography Quality Standards Act
Hawaii Revised Statues, Chapter 321-11(21) Sources of Ionizing Radiation
Hawaii Revised Statues, Chapter 466J, Radiologic Technology
Hawaii Administrative Rules, Title 11, Chapter 44, “Radiologic Technology Rules”
Hawaii Administrative Rules, Title 11, Chapter 45, “Radiation Control”
Links to Radiation Related Information:
Radiation Dose from Airport Scanners, Report of AAPM Task Group 217, American Association of Physicists in Medicine
The Facts About Depleted Uranium in Hawaii, Hawaii Dept. of Health Fact Sheet, August 2013
The Facts About Depleted Uranium in Hawaii, Hawaii Journal of Medicine and Public Health, November 2013
Electromagnetic Fields and Radiofrequency (Non-Ionizing):
EMF Electric and Magnetic Fields Associated with the Use of Electric Power, National Institute of Environmental Health Sciences, June 2002
Questions and Answers about Biological Effects and Potential Hazards of Radiofrequency Electromagnetic Fields , OET Bulleting 56, Federal Communications Commission, August 1999
What You Need to Know About RF Energy and 5G Cellular Networks, Hawaii Dept. of Health, October 2019
Fukushima Nuclear Disaster Info:
IRHB Fukushima Disaster Response Site, Hawaii Dept. of Health Information
Can’t open the PDF forms? If you do not have the Adobe Acrobat Reader installed on your computer, you need to install it before you can view and print the downloadable PDF files. The Acrobat Reader is free and can be downloaded to your computer by clicking on Adobe Reader.
Last update: March 23, 2021
Website maintained by Kristie Kasaoka Kimura