Prior to completing this form, accredited facilities wanting to add or replace a unit MUST:
Enter the additional unit information in the Manage Equipment section of your facility’s current
Online Accreditation application
and mark the prior unit as deactivated (if replaced).
Once the items above are completed, click "Proceed to Form" below to complete a brief application.
Once the form is received, you will be contacted by an IAC staff member via e-mail with instructions on securely uploading the following:
Documentation of medical physicist/qualified expert acceptance testing performed prior to clinical use to include radiation dose assessment, image quality assessment (that includes the QC phantom images) and post installation shielding verification survey.
5 days of routine operator quality control (QC) test results performed after the unit was installed that includes the QC log sheet/report that records the QC measurements and corresponding phantom images that display the QC measurements.
1 case study representative of each accredited testing area, the final report and a Scan Parameter Form.