Forms & Procedures

Radiation User Forms

• Authorized User Application (New User) - This form is to be filled out by a PI wishing to begin work with radioactive materials for the first time. The information will form the basis for adding the new user to our state license.
• Authorized User Renewal Form- This form is to be filled out by current users who are in need of renewing their user status. Users will be notified by the RSO when they are due for renewal.
• Declaration of Pregnancy - This form is used to make a voluntary declaration of pregnancy. This declaration is not required and may be withdrawn at any time.
• Dosimeter Application - This form is to be used by any radiation user who wishes to request dosimetry monitoring. Certain users are required to have monitoring, based upon their work, while it is voluntary for all others.
• Minor Changes to Nuclide Authorization - This form is for current users who are making modifications to a previously approved project.
• Protocol Summary - This form is submitted along with the Authorized User Application form and may also be requested as part of renewal or modification.
• Radioisotope Order Request - This form is required to be submitted to the RSO for approval prior to ordering radioactive materials.
• Radioisotope Use & Survey Log - This log is kept in the laboratory and used to track the usage of radioactive material inventory.
• Termination of RAM Work - This is required for users who are terminating their work with radioactive materials, so that our state license can be kept up to date.