Mammography Medical Physicists

The Registration Unit of the RHB​ authorizes physicists that provide mammography physics services. Approved physicists are called Mammography Medical Physicists. A current list of these individuals is provided below.

Forms

New Application

• ​CDPH 4255 (PDF) - Application for Authorization to Conduct Mammography Surveys in California
• Exemption regarding Direct Supervision of Surveys​ (PDF) (9-10-2024)

Renewal Application 

• CDPH 4255 R (PDF) - Application for Renewal of Authorization to Conduct Mammography Surveys in California
• ​​NOTE: To be eligible to evaluate/survey Dedicated Breast Computed Tomography (CT) units, please provide proof of at least 8 hours of new modality training in CT.
  

Name Address Change Form

• CDPH 8391 P (PDF) - Authorized Physicist Report of Name or Address Change

License Verification Request Form

• ​​CDPH 9151 (PDF)​ – Medical Physicists License Verification Request

CA Approved Mammography Medical Physicists

• Approved Mammography Medical Physicists​ (PDF)​
  

​Mammography Medical Physicist FAQs

​​​Offsite Diagnostic Review Workstation Exemption (PDF) ​​

Contact Information

• Submit applications and email questions/inquiries to: RHBRMT@cdph.ca.gov​​