Radiation Safety Forms

Radioactive Material (RAM) confirmation request form

You must receive a conformation number by completing the form at the above link prior to placing each order with the vendor.

Request for Radiation Dosimeter Form

Radiation workers who require personal dose monitoring badge must complete this form. Please refer to the radiation safety manual for the dosimetry requirements.

Working with high energetic radioactive materials or with x-ray generating units, a dose monitoring badge is required.

Please refer to the radiation safety manual for the criteria to wear a dosimeter badge.

Dose Estimate Form

Radiation workers must complete this form in case of loss of dosimetry badges. Please complete the form and submit to OEHS office.

NARM (Naturally Occurring and Accelerator-produced Radioactive Material ) Transfer Form

Radiation Workers who transfer NARM inter-campus must complete this form.

Laboratory Specific Training Form

This form previously called "Appendix L" must be completed by each radiation worker indicating the training completed and store in the the approved laboratory.

Monthly Contamination Check Form

This form must be used at the laboratories every month to check for contamination if there is an inventory of RAM (radioactive materials). 

Laboratory Layout diagram Form

This form can be used to draw the layout of the laboratory using radioactive materials to refer to the contamination check results.

Application for use of Ionizing Radiation (eprotocol)

Radiation Safety Committee (RSC) is transitioning to an electronic protocol system where you can complete the application and submit electronically.The submission and approval process is electronic and you will be notified afer your submission.If you have more questions, contact radiation safety at 577-1200.

Visit Division of Research eProtocol website for the link to eProtocol, training manuals, and for additional information about eProtocol.

Or access eProtocol directly.

In vivo radionuclide use-Imaging plan of work form (link)

Please complete the above form if you want to use Imaging Core at Elliman facility for invivo use of PET tracers on animals.