Get Nrc Form 313a (amp) - Ndhealth

Filling out the NRC Form 313A (AMP) for authorized medical physicist training and experience can seem complex. This guide provides clear, step-by-step instructions to assist users in completing the form accurately and efficiently online.

Follow the steps to complete the NRC Form 313A (AMP) online.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. In the 'Name of Proposed Authorized Medical Physicist' section, enter the full name of the individual who is seeking authorization.
3. Under 'Requested Authorization(s)', check all boxes that apply to the type of use being requested, such as ophthalmic use of strontium-90 or teletherapy units.
4. Proceed to Part I - Training and Experience. Select one of the three methods outlined for training and experience that corresponds to the applicant's qualifications.
5. If selecting 'Board Certification', attach a copy of the certification and provide details of training provider and dates as instructed.
6. If the applicant is a current authorized medical physicist seeking additional authorization, document the necessary training in section 3.c.
7. If using 'Education, Training, and Experience', document academic qualifications, including the degree, major field, and institution in the specified section.
8. Complete the required training and work experience details, ensuring to specify supervising individuals, locations, and types of medical physics experience.
9. Locate the 'Preceptor Attestation' section. This must be filled out by the preceptor who verifies the training and experience.
10. Ensure the preceptor signs and provides their contact information and license/permit number as required.
11. After carefully reviewing all sections for accuracy and completeness, save changes, and use options to download, print, or share the completed form.

Complete your NRC Form 313A (AMP) online today for a smoother submission process.