X-Rays

Service call form

To make an appointment with a physicist for the compliance of X-ray machines licensed by the INSPQ or any other X-ray machine that you would like to have checked.

Rendez-vous Rayons X EN

Verification type:

Dentisterie: Nombre d'appareils

*Number of devices to verify by type:

Intra-oral (cone)

Panoramic

Pan-Ceph

Pan-3D

Pan-Ceph-3D

3D only (i.e. CBCT or TVFC)

Other

Chiropractie: Nombre d'appareils

*Number of devices to verify by type:

Graphy

Scopy

Other

Podiatrie

Number of devices to verify by type:

Imagerie médicale: Nombre d'appareils

*Number of devices to verify by type:

Fixed graphy

Fixed scopy

Fixed graphy/scopy

Mobile graphy

Mobile scopy

Mobile graphy/scopy

Bone densitometry

Mammography

CT scan

Hybrid device PET/CT

Hybrid device SPECT/CT

Other

Specify for "Other" :

Industriel/Autre: Nombre d'appareil

Specify the type of equipment:

Number of devices to verify by type:

Reason for the verification:

Periodic verification

New equipment and new room

Device replacement in an existing room

Verification after repair

Other (specify) : Other (specify) :

Appointment date:

Start date

End date

Particular constraint for the period:

Important information:

1) The clinic must ensure that the equipment to be verified is accessible to the physicist at the time of the visit and a person familiar with the equipment must be present in order in particular to provide the information and access required for the verification.
2) Our normal opening hours are 8:00 a.m. to 5:00 p.m.
3) Your request will be processed in the next working days.

Contact information for the verification

File number:

Name of the institution:

Address:

City:

Postal code:

Administrative:

Name of the contact person:

E-mail address:

Phone number:

If you are human, leave this field blank.