Radiation Safety Forms

Commonly Used Forms

• New Dosimetry (Radiation Badge) Application - Login Required
• Dosimeter Orientation Information Sheet
  
• Lost or Damaged Personnel Dosimeter Form - Login Required
• Declaration/Undeclaration of Pregnancy Form - Login Required
• Lab Decontamination Form
• Radioactive Material Purchases Information
• Authorization to Place Radioactive Material Order in PeopleSoft - Login Required
  
• Documentation of Unused Radiation Badge - Login Required
• Pre-Procedure Interventional Consent - Form 8085
  
• Post-Procedure Interventional Follow-up - Form 8086
• Request for Extended Possession of Radioactive Material - Login Required
• Lab Sign for Radiation Spills & Emergency Procedures
• Notice to Employees, Oct. 2011 Revision

Permit Application Supplements

• RAM Permit - Training and Experience History - Non-Human Studies - Supplement A
• RAM Permit - Training and Experience History - Human Studies - Supplement B

Supplement C

• RAM Permit - Preceptor Statement - Diagnostic Uses
• RAM Permit - Preceptor Statement - Therapy Uses
• RAM Permit - Preceptor Statement - High Dose Radiotherapy
  

• Survey Map Template