Get Brc 202 3 Form

Filling out the Brc 202 3 form online requires careful attention to detail to ensure accurate reporting of occupational exposure. This guide will walk you through the necessary steps to complete the form efficiently and correctly.

Follow the steps to fill out the Brc 202 3 Form online

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling out Section 1 by entering the full name of the monitored individual in the format of last name, first name, and middle initial if applicable.
3. In Section 2, input the individual's identification number, ideally their 9-digit social security number or an alternative identification number, ensuring to include any punctuation.
4. For Section 3, choose the ID type by entering the appropriate code for the identification used (e.g., SSN for U.S. Social Security Number).
5. In Section 4, check the box indicating the sex of the individual being monitored.
6. Fill in Section 5 with the date of birth of the individual, using the MM/DD/YY format.
7. Indicate the monitoring period in Section 6, formatted as MM/DD/YY - MM/DD/YY.
8. In Section 7, enter the name of the licensee or registrant.
9. Provide the license or registration numbers in Section 8.
10. In Section 9A, mark either 'Record' or 'Estimate' based on the nature of the data provided.
11. For Section 9B, select either 'Routine' or 'PSE' based on the type of monitoring conducted.
12. Enter the radionuclide information in Section 10A, including the symbol for each radionuclide and fill out the following fields for intakes, including mode and associated doses.
13. Complete Sections 11 to 18 with the relevant dose equivalents and totals as specified.
14. In Section 19, provide any additional comments that may assist in compliance and clarification.
15. Sign the form in Section 20, indicating the individual responsible for its accuracy.
16. Lastly, enter the date the form was prepared in Section 21.
17. Review all entries for accuracy and completeness before proceeding to save changes, download, print, or share the completed form.

Complete your Brc 202 3 Form online today to ensure timely and accurate reporting.