Persons requesting that the department approve a healing arts screening program shall submit the following information and evaluation:
1. Name and address of the applicant and, where applicable, the names and addresses of agents within this state.
2. Diseases or conditions for which the x-ray examinations are to be used in diagnoses.
3. A detailed description of the x-ray examinations proposed in the screening program.
4. Description of the population to be examined in the screening program, i.e., age, sex, physical condition, and other appropriate information.
5. An evaluation of any known alternate methods not involving ionizing radiation which could achieve the goals of the screening program and why these methods are not used instead of the x-ray examinations.
6. An evaluation by a qualified expert on the x-ray systems to be used in the screening program. The evaluation by the qualified expert shall show that such systems do satisfy all requirements of this article. The evaluation shall include a measurement of patient exposures from the x-ray examinations to be performed.
7. A description of the diagnostic x-ray quality control program.
8. A copy of the technique chart for the x-ray examination procedures to be used.
9. The qualifications of each individual who will be operating the x-ray systems.
10. The qualifications of the individual who will be supervising the operators of the x-ray systems. The extent of supervision and the method of work performance evaluation shall be specified.
11. The name and address of the individual who will interpret the radiographs.
12. A description of the procedures to be used in advising the individuals screened and their private practitioners of the healing arts of the results of the screening procedure and any further medical needs indicated.
13. A description of the procedures for the retention or disposition of the radiographs and other records pertaining to the x-ray examinations.
14. An indication of the frequency of screening and the duration of the entire screening program.
N.D. Admin Code tit. 33.1, art. 33.1-10, ch. 33.1-10-06, app E