Medical and Academic Licensing

Instructions to Apply for a License for
Human Use of Radioactive Material

The following forms should be used when applying for a new license or renewing an existing license or if adding a new authorized physician user..

• License Application for Human Use of Radioactive Materials - BRC Form 252-2a

• Preceptor Statement For License Application - BRC Form 252-2b.

Regulatory Guide 3.1 can be used for guidance in completing the above forms.

Other Guidance Information

Supplemental guidance information is available for the following uses of radioactive material.

• Use of Xenon-133 - worksheet and information required, in addition to license application.
• Brachytherapy - safety guidelines for a brachytherapy program
• Low energy seeds - amendment criteria for low energy seeds; receipt, use and disposal log; radiation safety checklist and room survey.
• Bioassay requirements for I-125 and I-131.
• PET radiopharmaceuticals - amending a license to add PET radiopharmaceuticals.
• Out patient radionuclide therapy information.
• Implant log and survey.
• Medical subsites - guidance for adding a subsite not associated with a move of the facility and a checklist for adding a new site.

Additional information and instructions can be found below:

• Instructions to add a site for medical uses
• Amendment to add a physician to a license

BRC Policy on Medical Practice for Diagnostic Nuclear Medicine

A radioactive material license which authorizes medical use of radioactive material may constrain the actions of the licensed entity. In accordance with the Medical Practice Act Section 1.02.(8), nothing in a license issued for medical uses of radioactive material shall be construed as limiting the clinical administration of Food and Drug Administration approved pharmaceuticals to a patient for imaging and localization studies by an appropriately approved physician user named on the license.

September 2, 1997

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Texas Department of State Health Services, Radiation Control Program
1100 West 49th Street - Austin, Texas 78756-3189 - (512) 834-6688 or (512) 834-6770

Last Updated September 27, 2006