Communications

Please download PDF forms to your desktop to fill out.

An undertaking must use these notification forms to submit statutory notifications to HIQA under European Union (Basic Safety Standards for Protection Against Dangers Arising from Medical Exposure to Ionising Radiation) Regulations 2018 (S.I. No. 256 of 2018). These forms should be sent to radiationprotection@hiqa.ie

  • NF200

    Declaration of Undertaking - standard form

    Timeframe Existing undertakings must submit by the 8 April 2019. New undertakings must submit 1 month prior to commencing practice.
    NF200-Declaration-of-Undertaking.pdf323.45 KB
  • NF200A

    Declaration of Undertaking - listed practitioners

    Timeframe Existing undertakings must submit by the 8 April 2019. New undertakings must submit 1 month prior to commencing practice.
    NF200A.pdf400.48 KB
  • NF201

    Change of undertaking details

    Timeframe As needed when any details in relation to undertaking changes
    NF201-Change-of-undertaking-details.pdf791.55 KB
  • NF202

    Cessation of practice

    Timeframe 1 month in advance of ceasing practice
    NF202-Cessation-of-practice.pdf113.65 KB
  • NF211

    Significant event notification

    Timeframe Within 3 working days of discovery of the incident
    NF211-Significant-event-notification-form.pdf314.73 KB