Radiation-Emitting Products

Confirmation Notice

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Scheduling the MQSA Inspection:

After the inspection has been scheduled with the facility, the following confirmation notice should be sent to the facility, completely filled out. The confirmation notice should be faxed to the facility as a first option and mailed if the facility does not have fax capabilities. This notice should always provide a telephone number to allow the facility to contact you regarding any questions they might have about the inspection or problems with the proposed date and time.

To minimize time spent at the facility during the inspections, inspectors may make arrangements with facilities to review documents submitted to the inspector’s office prior to the inspection. If this arrangement has been made, the inspector should mention this in the confirmation notice as a reminder.

MQSA Inspection Confirmation Notice

This notice confirms our telephone conversation of {insert date here} regarding the scheduled inspection. If you have questions, contact the inspector at the telephone number below.

  • Date and time of inspection:
  • Name and address of facility:
  • Facility person contacted:
  • Facility telephone number:
  • Inspector name:
  • Inspector office address:
  • Inspector telephone number:
  • Inspector fax: number:
The MQSA inspection will cover the following areas:
  • Equipment performance (including image quality and dose)
  • Technologist and physicist quality control/quality assurance (QC/QA) tests and tasks
  • Medical audit and outcome analysis records
  • Medical records (mammography reports and films)
  • Personnel qualification records

The average on-site inspection time is approximately six hours.

  • Testing for each mammography x-ray unit, darkroom and film processor combination takes approximately one hour.
  • The remainder of the inspector's time will be spent reviewing facility records. We recommend that you schedule a block of time for the testing of each x-ray unit and film processor combination to help minimize any inconvenience to patient care from the inspection process. For the remainder of the inspection time, staff may conduct their usual duties but should be available to the inspector during the records review portion, should he or she have questions or need assistance.


Page Last Updated: 07/08/2014
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