Class II Surgical

NEW MEDICAL CLASS II SURGICAL LASER REGISTRANTS OR FACILITIES WITH CHANGE OF OWNERSHIP

Complete:

• Non-Ionizing Facility Registration (ARRA-NIR) to register facility
• Non-Ionizing Facility Registration (ARRA-NIMI) - Nonionizing Machine Information
  for EACH laser unit you are going to utilize
• Provide a Medical Director Medical Director Acknowledgement (Non-Cosmetic)
• Provide a Laser Safety Officer LSO Acknowledgement Statement
• Send in fee**

* Laser Operators must currently meet A.A.C. Requirements-R12-1-1440 (est. Page 226) and must be authorized by law to utilize lasers for surgical procedures per their licensing board. 
**Fees will be $47.00 for each Laser head device.

You will need to provide all the above to complete the process of your application. Do not leave any blank spaces, incomplete forms will be returned.

CURRENT REGISTRANTS THAT WANT TO RENEW, CHANGE FACILITY NAME, OR CHANGE ADDRESS

Complete:

• Non-Ionizing Facility Registration (ARRA-NIR) to register facility
• No fee***

CURRENT REGISTRANTS THAT WANT TO MAKE AN AMENDMENT TO THEIR REGISTRATIONS, (ADD/REMOVE UNITS, OR CHANGE CERTIFYING OFFICIAL, MEDICAL DIRECTOR, LSO)

Complete:

• Non-Ionizing Machine Information (ARRA-NIMI) - Nonionizing Machine Information
  for EACH laser unit you are going to utilize
• No fee***

Unless already provided or different from posted registration, please also submit the following:

• Provide a Medical Director Medical Director Acknowledgement (Non-Cosmetic)
• Provide a Laser Safety Officer LSO Acknowledgement Statement

You will need to provide all the above to complete the process of your application. Do not leave any blank spaces, incomplete forms will be returned.