Get Dosimeter Request Form - University Of North Florida - Unf

Filling out the Dosimeter Request Form is an essential step for users requiring radiation monitoring at the University of North Florida. This guide will provide a clear and step-by-step approach to assist you in completing the form accurately and efficiently.

Follow the steps to complete your Dosimeter Request Form

1. Click the ‘Get Form’ button to access the dosimeter request form and open it in the online editor.
2. Fill in your name in the designated field. Ensure to use your full legal name as required.
3. Provide the date of your request in the space provided. This should be the date you are submitting the form.
4. Enter your current address. Be sure to include street address, apartment number if applicable, city, state, and zip code.
5. Input your Social Security Number (SSN) and Date of Birth (DOB) in the specified fields; this information may be necessary for processing your request.
6. Indicate the validity period for the dosimeter by checking either the 'Temporary (> 6 months)' or 'Permanent (< 6 months)' option, according to your monitoring need.
7. Fill in the name of your Primary User, which can be your Primary Investigator or Professor.
8. Read the acknowledgment statement regarding the University of North Florida Radiation Safety Program and confirm your understanding by providing your signature in the designated area.
9. If applicable, the authorized assistant should sign to indicate their acknowledgment as well. Ensure their name appears above their signature.
10. Finally, review all the information filled out for accuracy. Once verified, you can save changes, download, print, or share the form as necessary.

Take the next step towards radiation safety by completing your Dosimeter Request Form online today!