Pennsylvania Accelerator Program--Application & Instruction Forms

Pennsylvania Accelerator License Application & Instruction Forms

Medical Accelerator Licenses

Application and Fee Schedule for a Medical Accelerator License (PDF)
- DEP Document #2900-PM-RP0042
- Part I—Accelerator Facility Information (Word)
  - DEP Document #2900-PM-RP0042b
- Part II—Accelerator Information (Word)
  - DEP Document #2900-PM-RP0042d
- U.S. Nuclear Regulatory Commission (NRC) Forms:
  - Authorized User:
    - Authorized User Training and Experience and Perceptor Attestation (PDF)
      - NRC Form 313A (AUS)
  - Authorized Medical Physicst:
    - Authorized Medical Physicist Training and Experience and Preceptor Attestation (PDF)
      - NRC Form 313A (AMP)
  - Radiation Safety Officer:
    - Radiation Safety Officer Training and Experience and Preceptor Attestation (PDF)
      - NRC Form 313A (RSO)
Renewal Application for Medical and Non-Medical Accelerators
- DEP Document #2900-PM-RP0048
- Renewal Application for Medical and Non-Medical Accelerators (PDF)
- Renewal Application for Medical and Non-Medical Accelerators (Word)

Non-Medical Accelerator Licenses

Fee Schedule for Non-Medical Accelerator Licenses (PDF)
- DEP Document #2900-PM-RP0041
Application Instructions for a Non-Medical Accelerator License—Part I (PDF)
- DEP Document #2900-PM-RP0041a
Application for a Non-Medical Accelerator License—Part I
- DEP Document #2900-PM-RP0041b
- Application for a Non-Medical Accelerator License—Part I (PDF)
- Application for a Non-Medical Accelerator License—Part I (Word)
Application Instructions for a Non-Medical Accelerator License—Part II (PDF)
- DEP Document #2900-PM-RP0041c
Application for a Non-Medical Accelerator License—Part II
- DEP Document #2900-PM-RP0041d
- Application for a Non-Medical Accelerator License—Part II (PDF)
- Application for a Non-Medical Accelerator License—Part II (Word)

Amending or Terminating Accelerator Licenses

Application for an Amendment or Termination of an Accelerator License
- DEP Document #2900-PM-BRP0043
- Application for an Amendment or Termination of an Accelerator License (PDF)
- Application for an Amendment or Termination of an Accelerator License (Word)
U.S. Nuclear Regulatory Commission (NRC) Forms:
- Authorized User:
  - Authorized User Training and Experience and Perceptor Attestation (PDF)
    - NRC Form 313A (AUS)
- Authorized Medical Physicst:
  - Authorized Medical Physicist Training and Experience and Preceptor Attestation (PDF)
    - NRC Form 313A (AMP)
- Radiation Safety Officer:
  - Radiation Safety Officer Training and Experience and Preceptor Attestation (PDF)
    - NRC Form 313A (RSO)

Current Accelerator Facilities

Active Accelerator Facilities in Pennsylvania (Excel)
- Download the Accelerator Facility List legend (PDF)