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Please fill out the form below to have a West Physics representative contact you to arrange for a service or product quote for your facility.

Our address and telephone numbers are:

West Physics
3825 Paces Walk SE
Suite 250
Atlanta, GA 30339

770-435-9186 • 1-866-275-WEST (9378) • FAX 770-599-2333

Office Hours: West Physics maintains liberal office hours for the convenience of our customers nationwide.

Monday-Friday:

9AM – 8PM Eastern Time
8AM – 7PM Central Time
7AM – 6PM Mountain Time
6AM – 5PM Pacific Time

Closed Weekends & U.S. National Holidays

Request a quote

Radioactive Materials License (RAML) Amendment Request

All amendment requests must be on your company letterhead and signed by an officer of the facility (e.g. CEO or designate).

  • Please Submit The Following Along With The Request.

  • If Adding An Authorized User:

    • NRC Form 313A signed by preceptor
    • If the proposed AU is board-certified, a copy of the board certificate and evidence of maintenance of certification if past its printed validity date
    • If the proposed AU is authorized for the same use on another RAML, a copy of that RAML (does not have to be the current version of that RAML)
    • List of intended uses (refer to current RAM license)
  • If Adding Authorized Medical Physicist:

    • NRC Form 313A(AMP) signed by preceptor
    • If the proposed AMP is board-certified, a copy of the board certificate and evidence of maintenance of certification if past its printed validity date
    • If the proposed AMP is authorized for the same use on another RAML, a copy of that RAML (does not have to be current version of that RAML)
    • Proof of safety training on equipment to be used for, e.g., HDR units and other manual brachytherapy units
  • If Adding A Type Of Use (New Procedure or Product):

    • Product/procedure name
    • List of Authorized Users for new use (submit documentation needed for all new AUs above)
    • Other documents may be required depending on the new use, (i.e., safety procedures and equipment, department diagram, storage and waste procedures, bioassay procedure)
  • If Adding A Location Of Use:

    • New address
    • Use type or modalities to be used at new location
    • Requested Start Date
    • Facility diagram of rooms where RAM will be used, with room numbers. Include a map showing where contamination surveys will be performed and the locations of any security devices (locks, keypads, cameras, employee badge readers, etc
    • If a private practice, statement regarding where patients will be transferred in the case of an emergency
  • If Changing RSO:

    • Contact information (name, phone number and email address) of new RSO
    • Delegation of authority memorandum on company letterhead announcing new RSO responsibilities
    • Signed NRC 313A(RSO) form or attestation letter that confirming RSO's qualifications, signed by preceptor
    • A copy of the RAML on which the preceptor is named as RSO (does not need to be current version of RAML)
    • If the proposed RSO is board-certified, a copy of the board certificate and evidence of maintenance of certification if past its printed validity date
      • IMPORTANT NOTE: If the proposed RSO is an Authorized User, Authorized Medical Physicist, or Authorized Nuclear Pharmacist listed on your license, he/she must be trained in radiation safety, regulatory issues, and emergency procedures for all types of medical use on the license, not just the ones he/she is authorized to perform, in order to be eligible as RSO
  • If A Room Within Your Facility Will Permanently Discontinue Using RAM:

    • Effective date
    • Once all sources have been transferred or disposed, West Physics will perform a close-out survey
    • Shipping Manifest showing transfer of sources signed by your facility and a representative of the site receiving the sources, or by a third party
  • If Change of Ownership or Transfer of Control:

    • Review the NRC guidance on changes of control, specifically Part 5 detailing the information that needs to be submitted
    • Consult with your legal representative to provide items 5.1 through 5.6 in the above document
    • Submit at least 30 days prior to the effected change
  • Note that, although all states should accept NRC forms, they may require you to use state-specific forms if they do exist. If you are not familiar with licensing procedures in your state, please submit as much of the above documentation as you can, and a representative will follow up with you.

  • Drop files here or

*Indicates a Required Field