Get Nrc Form

Completing the Nrc Form online is a straightforward process that ensures accurate recording of an individual's lifetime occupational exposure to radiation. This guide will walk you through each section of the form, providing clear instructions for filling it out correctly.

Follow the steps to fill out the Nrc Form online with ease.

1. Press the ‘Get Form’ button to obtain the form and open it in your chosen editor.
2. Type or print your full name in the designated format: last name, first name, middle initial (if applicable).
3. Enter your identification number, such as a Social Security number if available, or another official identifier.
4. Select the corresponding code for the type of identification used, such as SSN for Social Security Number.
5. Indicate your sex by checking the appropriate box provided on the form.
6. Fill in your date of birth using the format MM/DD/YYYY.
7. Provide the monitoring period for the report, formatted as MM/DD/YYYY - MM/DD/YYYY.
8. Input the name of the facility or licensee that conducted the monitoring.
9. Enter the NRC license number or numbers if applicable.
10. Choose ‘Record,’ ‘Estimate,’ or ‘No Record’ based on the dose data provided.
11. Select either ‘Routine’ or ‘PSE’ to denote the type of exposure monitoring.
12. Fill in the deep dose equivalent (DDE) for the whole body.
13. Complete the eye dose equivalent (LDE) for the lens of the eye.
14. Enter the shallow dose equivalent for the skin of the whole body (SDE, WB).
15. Provide the shallow dose equivalent recorded for the skin of the extremity with the maximum dose (SDE, ME).
16. Input the committed effective dose equivalent (CEDE).
17. Fill in the committed dose equivalent (CDE) for the maximally exposed organ.
18. Calculate and enter the total effective dose equivalent (TEDE), which is the sum of the DDE and CEDE.
19. Sign the form where indicated to certify the information provided is accurate.
20. Enter the date the form is signed.
21. If required, have the designated representative or employer sign the form where indicated.
22. Review all sections for completeness and accuracy.
23. Once completed, save your changes, download a copy, print, or share the form as needed.

Start filling out your Nrc Form online today!