DD Form 2164. X-Ray Verification/Certification Worksheet

DD Form 2164, known as the X-Ray Verification/Certification Worksheet, is used by military medical personnel to verify and certify the accuracy of X-ray equipment calibration and performance.

The form consists of sections where users document information about the X-ray equipment, the testing procedure, results, and certification. It includes fields for equipment identification, testing parameters, measured values, and remarks.

Instructions for filling out DD Form 2164 involve conducting the X-ray equipment calibration tests as specified in the form, recording accurate measurements, and providing any necessary remarks. Thorough testing and documentation ensure the reliability and safety of the equipment.

Application Example: Military healthcare facilities would use DD Form 2164 to periodically verify the accuracy of X-ray equipment used for medical imaging. By ensuring that the equipment is properly calibrated, healthcare providers can trust the diagnostic quality of the images and maintain patient safety.

Additional Documents Needed: Equipment calibration standards, testing protocols, and related documentation might be required.

Related Forms: Alternatives may include other calibration and testing forms used for different types of medical equipment, but DD Form 2164 specifically focuses on X-ray equipment verification.