IAC CT Multiple Site Checklist
Several items must be completed in the Online Accreditation Account and documents must be submitted when adding additional sites that are included in the checklist below:
Complete the following items in the facilities Online Accreditation Account:
Enter the additional site(s) in the Manage Sites section
Enter the additional CT unit(s) information in the Manage Equipment section
Enter all additional medical staff members and technical staff members in the Manage Staff section (if appropriate)
Submit the following documentation via a traceable carrier such as UPS or FedEx:
A Multiple Site Supplemental Application
A formal letter of notification from the Medical or Technical Director that the facility has added a CT site
Documentation of medical physicist/qualified expert’s report of radiation dose assessment and image quality assessment (that includes the QC phantom images that can be in a .pdf or .jpeg format)
A post installation radiation shielding verification survey performed by the medical physicist/qualified expert.
5 days of routine operator quality control (QC) test results performed after the CT unit was installed that includes the QC log sheet/report records the QC measurements and corresponding phantom images that display the QC measurements (the QC phantom images can be in a .pdf or .jpeg format)
A total of 6 case studies per CT unit that are representative of all accredited testing areas. Each case study must contain all images on a CD, DVD, or memory stick (flash drive) in a DICOM format with the DICOM viewer installed, the final report, and a CT Scan Parameter Form. View theCase Studies Requirements for guidance related to the types of CT examinations to be submitted.
Multiple site fee: $1,325per site/unit (2-3); $1,085per site/unit (4-10) (20% discount); $875per
site/unit (over 10)
Submit requested documentation to:
IAC CT
6021 University Boulevard, Suite 500
Ellicott City, MD 21043
IAC CT Multiple Site Checklist
Revised 1-15-2018