Department of Public Health

State of Alabama

Official Website: https://www.alabamapublichealth.gov

Forms & Documents

Browse all Department of Public Health government forms

141 - 160 of 195 forms

Form Title Topics
Preceptor Form for Individuals Wishing to be Authorized as Therapeutic Medical Physicists Radiation
Preceptor Form for Individuals Wishing to be Authorized as Therapeutic Medical Physicists Radiation
Preceptor Form for Individuals Wishing to be Authorized for Medical Use Radiation Safety Officer Radiation
Preceptor Form for Physicians Wishing to be Authorized for Use of Sealed Source Radioactive Materials for which a Written Directive is Required Radiation
Preceptor Form for Physicians Wishing to be Authorized for Use of Unsealed Radioactive Materials and Diagnostic Sealed Sources for which a Written Directive is Not Required Radiation
Preceptor Form for Physicians Wishing to be Authorized for Use of Unsealed Radioactive Materials for which a Written Directive is Required Radiation
Pre-Renovation Form Lead Certification
Procedure to Replace a Lost or Misplaced Radiographer Certification ID Card - Radiographer Card Replace Radiation
Procedure to Upgrade Radiographer Certification ID Card from Single Purpose (Example: X-Ray Only) to Dual Purpose (Both X-Ray and RAM) - Radiographer Second Card Radiation
Procedure to Upgrade Radiographer Certification ID Card from Single Purpose (Example: X-Ray Only) to Dual Purpose (Both X-Ray and RAM) - Radiographer Second Card Radiation
Program Summary ABCCEDP, ABCCEDP
Provider Contract $15,000 & Over: June 30, 2017 - June 29, 2019 ABCCEDP, ABCCEDP
Provider Contract Under $15,000: June 30, 2017 - June 29, 2019 ABCCEDP, ABCCEDP
Provider Manual ABCCEDP, ABCCEDP
Public Health Monitors Swine Flu Outbreak Madison County
Radiation Safety Training Certificate for Servicers of X-Ray Equipment Radiation
Radioactive Material Application Addendum for Industrial Radiography (Corporate Structure Radiation
Radiological Emergency Assistance Form Radiation
Regional Coordinator Contact List ABCCEDP, ABCCEDP
Regional Coordinator Map ABCCEDP, ABCCEDP

Contact Information & Office Locations

All 2 contact points

ADPH

Address:
201 Monroe Street
The RSA Tower
Montgomery, AL 36104

Phone numbers:
  • (334) 206-5200

AUTAUGA

EAST CENTRAL DISTRICT

Address:
219 N. Court St
Prattville, AL 36067

Phone numbers:
  • (334) 361-3743
  • (334) 358-2002
Fax numbers:
  • (334) 361-3718
  • (334) 361-3806

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