How to Register an X-Ray System in Georgia: A Step-by-Step Guide

Setting up a new x-ray system in Georgia? Here's the biggest surprise for anyone coming from a state like Texas, Florida, or Hawaii: Georgia doesn't require the person operating the machine to hold a state technologist license at all. That doesn't mean it's a light-touch state, though — the facility side comes with a $300 application fee, a shielding design that has to be approved by the state before you finish construction, and real penalties for skipping registration. Here's exactly how it works.

Georgia regulates x-ray equipment through the Department of Community Health (DCH), Healthcare Facility Regulation Division (HFRD), X-Ray Program — under Georgia Comp. R. & Regs. Chapter 111-8-90 (Rules and Regulations for X-Ray), sometimes still referenced under its older Department of Public Health chapter number, 290-5-22. Every user of a radiation machine in the state — medical, dental, veterinary, podiatric, chiropractic, industrial, or security screening — registers through this same division, regardless of facility type.

Here's a complete walkthrough of how registration works with HFRD, what your facility and your operators each need, and the requirements — shielding, dosimetry, inspections — that come with owning and running an x-ray system in Georgia.

Two Separate Requirements — But One of Them Looks Different Here

Every state splits oversight into a facility side and a people side. Georgia still does both, but the second half works differently than in most states:

Who Needs to Register

Under Rule 111-8-90-.02, all users of radiation machines in Georgia are required to register with DCH/HFRD — there's no separate registry run by Georgia's Environmental Protection Division for this equipment. EPD handles radioactive materials (sealed sources, isotopes); machine-generated x-ray of every kind goes through HFRD instead. That covers:

• Hospitals, medical offices, and imaging centers
• Dental, veterinary, podiatric, and chiropractic practices
• Non-medical and industrial users — manufacturers, universities, and government agencies
• Security x-ray units

A narrow set of equipment is exempt from registration: electronic devices that produce only incidental radiation and stay under 0.5 mrem per hour at 5 cm from any accessible surface (the classic example being an old CRT television), plus machines that are inoperable, in transit, or in storage and not in use. If your equipment doesn't fall into one of those categories, it needs to be registered before it's used — not after.

The Registration Process, Step by Step

1. If you're building or renovating a room for the machine, get a qualified medical physicist involved before your architect finalizes drawings. Under Rule 111-8-90-.01, shielding designs for facilities with permanently installed x-ray equipment in an enclosed room must be submitted to DCH for approval prior to construction — not just submitted for the record, but actually approved before you build. Bone densitometers and most non-medical/industrial installations are exempt from this shielding-plan step, except when they're installed in an enclosed room. See the shielding section below for exactly what the submission has to contain.
2. File a separate registration application for each facility through the online portal at forms.dch.georgia.gov/Forms/xrayv2. One registration doesn't cover multiple locations, even under common ownership.
3. Certify compliance with Chapter 111-8-90 as part of your initial application, and submit your shielding specifications together with a test result report prepared to National Council on Radiation Protection (NCRP) standards, where a shielding plan is required.
4. Submit the required supporting documents: a completed registration application, an affidavit, and picture identification, in addition to the shielding materials above where applicable.
5. Pay the application fee. Initial Certificates of Registration for X-Ray Users carry a $300 application fee. The recurring annual activity fee that used to apply to existing registrants has been temporarily suspended while HFRD finishes revising its x-ray rules — confirm the current fee status directly with HFRD before assuming either way, since this is explicitly a temporary condition tied to a pending rule update.
6. Renew at the interval HFRD sets. The rule doesn't spell out an exact renewal calendar (it says renewal happens "at intervals as required by the Department"), but the fee has historically been described as an annual activity fee, so budget for yearly contact with the department even while the fee itself is paused.
7. Register again, not just update, if your facility changes hands. A change in ownership, a name change, or a relocation requires a brand-new registration — you can't simply amend the existing one. Keep this in mind if you're buying an existing practice along with its equipment.
8. Make sure your operators get their training started. This runs in parallel with facility registration, not after it — see the operator section below for exactly what's required and by when.

Skipping registration altogether isn't a paperwork problem you can fix later without consequence: Rule 111-8-90-.02 sets a civil penalty of up to $1,000 for failing to register as required.

What You'll Need on Hand

Shielding & Lead Lining: What Your Walls Actually Need

Georgia's shielding process looks a lot like Hawaii's in one important respect: the state doesn't just receive your shielding design, it has to approve it before construction happens. Rule 111-8-90-.01 requires that shielding designs for permanently installed equipment in an enclosed room be submitted to DCH for approval prior to construction of a new facility (or modification of an existing one) — and once approved, you're required to keep a copy of the approved design on file for inspection.

Georgia's rule also specifies exact lead-equivalent numbers rather than leaving it entirely to a physicist's discretion: staff and ancillary personnel who must remain in the room during an exposure need to be protected by aprons or whole-body barriers of at least 0.25 millimeter lead equivalent, and the same 0.25 mm lead equivalent standard applies to patient gonad shielding, which must be available and used whenever the gonads fall in the useful beam (except where it would interfere with the diagnostic information needed). Operators generally have to work from a protected position that meets these same requirements, with specific exceptions carved out for dental intraoral, veterinary, and portable x-ray use, where the nature of the exam makes a fully shielded operator position impractical.

New Equipment: Federal Assembly Reports Still Apply

Georgia's own rules don't create a state-specific "report of assembly" form the way some states do, but that doesn't remove the federal obligation. If your system is a certified diagnostic x-ray unit, or is assembled from components made by more than one manufacturer, federal law (21 C.F.R. §1020.30) still requires whoever assembles it to file FDA Form 2579 (Report of Assembly) — this comes from the FDA regardless of what any individual state requires, so don't assume "Georgia doesn't ask for it" means no one does.

Renewal, Fees & Verification

Here's the fee picture as of this writing, though it's worth confirming directly with HFRD since it's tied to a rulemaking in progress:

Renewal itself happens "at intervals as required by the Department" under the rule's own language, without a fixed calendar spelled out in the text — in practice, treat it as an annual touchpoint given how the fee has historically been structured, and confirm your facility's specific renewal date with HFRD directly.

Operator Training: Why Georgia Doesn't Use a State License (Mostly)

This is the section that most surprises anyone used to Texas, Florida, or Hawaii's operator-licensing schemes. For general radiography, Georgia does not require the person operating the machine to hold a personal state license. Instead, Rule 111-8-90-.04 puts the obligation on the registrant (the facility): operators must receive, at minimum, six hours of instruction, and the facility keeps the proof on file rather than the operator carrying a state-issued credential.

Training has to start within 30 days of employment and be completed within 90 days. A person who provides written proof of completing this instruction is considered to meet Georgia's operator qualification standard — there's no state exam and no ongoing state-mandated continuing education tied to it. The facility is the one that has to maintain those training records for department inspection, so build this into your onboarding checklist for every new hire who will touch the machine, not just your imaging staff.

One important, narrower exception: nuclear medicine technologists and radiation therapists are not covered by the six-hour rule — they fall under a separate certification requirement (Georgia Board of Natural Resources Rule 391-3-17, since their work involves radioactive material rather than just a machine). Nuclear medicine technologists must hold NMTCB or ARRT(N) certification, or be eligible to sit for one of those exams within 12 months of starting; radiation therapists need ARRT(T) certification, or board-eligibility within 12 months. A grandfather provision exempts anyone employed in these roles before September 1, 2024, as long as they don't change employers.

Because Georgia's rule ties the training requirement to "persons operating a radiation machine" rather than listing profession-based exemptions the way some states do, we did not find language in Chapter 111-8-90 carving out physicians, chiropractors, podiatrists, or veterinarians from the six-hour training itself — the requirement appears to apply based on the act of operating the machine, not the operator's professional license. If your practice is a chiropractic, podiatric, or veterinary office and you're relying on the treating practitioner to personally operate the equipment, confirm directly with HFRD that your specific setup satisfies the training and recordkeeping requirement, rather than assuming a professional license alone covers it.

Personnel Monitoring: Who Needs a Dosimeter Badge

Georgia's dosimetry threshold is set differently than several other states: monitoring is required for anyone likely to receive a dose exceeding 25% of the applicable occupational dose limit in a calendar quarter (not the 10% threshold used in some other states), and monitoring is required for everyone under 18 who enters a controlled area, regardless of expected dose.

• Whole body, head and trunk, active blood-forming organs, lens of the eyes, or gonads: 1¼ rem (12.5 mSv) per calendar quarter
• Hands, forearms, feet, and ankles: 18¾ rem (187.5 mSv) per calendar quarter
• Skin of the whole body: 7½ rem (75 mSv) per calendar quarter

These figures are expressed per calendar quarter rather than per year, which is worth noting if you're used to comparing against annual limits used elsewhere. For members of the public and other non-occupationally-exposed individuals, the limit drops to one-tenth of the occupational values, and uncontrolled areas have to stay low enough that no one there could receive more than 2 millirem in any one hour or 100 millirem in any seven consecutive days.

Signage: Georgia Requires It (The Opposite of Some States)

Worth flagging if you've read up on other states first: Georgia's rule requires posted signage bearing the radiation symbol and specific wording. Radiation areas must be posted "CAUTION – RADIATION AREA," and high radiation zones require "CAUTION – HIGH RADIATION AREA." This is a direct contrast to states where posted signage isn't required at all — don't assume the rule you read about for one state carries over to Georgia.

Inspections & Staying Compliant

HFRD's inspection authority is broad: registrants must afford the Department "at all reasonable times" the opportunity to inspect radiation machines and the premises, and to review any records required to be maintained under Chapter 111-8-90. The rule describes inspections as periodic without committing to a fixed interval, so treat "we could be inspected at any time" as the operating assumption rather than waiting for a set schedule.

• Current registration on file and available for review
• Approved shielding design kept on file, matching what was actually built
• Operator training records showing the six-hour requirement was met on time for every operator
• Personnel monitoring records for anyone required to wear a dosimeter
• Posted "CAUTION" signage where required

If an inspection turns up a compliance issue, you generally have 60 days to notify the Department of corrections after receiving a non-compliance notice. Georgia's enforcement toolkit goes further than a lot of states': beyond the $1,000 civil penalty for failing to register, the Department has explicit authority to impound equipment during emergencies or serious non-compliance, and can pursue legal action for condemnation and destruction of impounded sources in the most serious cases. That's a meaningfully bigger stick than most states' registration programs carry, even though the day-to-day paperwork burden is lighter on the operator-licensing side.

One more note if portable or mobile equipment is part of your plans: Georgia has its own set of operational rules for that equipment that go beyond standard facility registration — see our dedicated post on Georgia portable x-ray regulations for the details.

Quick-Reference Checklist

Helpful Links

• X-Ray Program – Georgia Department of Community Health, HFRD
• Online X-Ray Registration Portal
• HFRD Licensing Fees
• Ga. Comp. R. & Regs. Chapter 111-8-90 – Rules and Regulations for X-Ray
• Rule 111-8-90-.01 – General Provisions (Shielding, Inspections)
• Rule 111-8-90-.02 – Registration
• Rule 111-8-90-.03 – Standards for Protection Against Radiation
• Rule 111-8-90-.04 – X-Rays in the Healing Arts (Operator Training)
• Georgia Society of Radiologic Technologists – Licensure Advocacy
• FDA Form 2579 – Report of Assembly of a Diagnostic X-Ray System
• Georgia Portable X-Ray Regulations – Maven Imaging

This post summarizes publicly available Georgia Department of Community Health, Healthcare Facility Regulation Division information as of July 2026 for general planning purposes and is not legal advice. Requirements, fees, and processing timelines can change — particularly the annual activity fee, which HFRD describes as temporarily suspended pending a rule revision — so always confirm current steps and fees directly with HFRD before relying on this guide for a filing.