Get Radiation Worker Registration Form - Environmental Health And ... - Ehs Neu

Completing the Radiation Worker Registration Form is an essential step for individuals preparing for Radiation Safety Training. This guide will provide you with clear instructions on how to accurately fill out the form online, ensuring a smooth registration process.

Follow the steps to complete your registration form online:

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the ‘Personal Information’ section, fill in your first name, last name, date of birth, and select your status as a student or other category. Provide your gender and middle initial, followed by either your social security number or student ID number. Also, include details about your term of employment, department, room/building, extension, principal investigator's name, room number, and extension.
3. In the ‘Radioactive materials: Prior Experience and Training’ section, respond to the questions by checking the appropriate answer. If you have worked with radioactive materials before, proceed to answer all questions; otherwise, skip to question 4.
4. For question 4a, check all radiation sources you will be working with, including H-3, C-14, P-32, S-35, Rb-86, Tc-99m, I-125, and In-111.
5. In question 4b, list any additional radiation sources not mentioned previously. Fill in the necessary details about the facilities where you have worked, including the address, city, state, and employment start and end dates for each facility.
6. After completing the form, ensure that you have signed in the designated spaces for both the radiation worker and the principal investigator or supervisor. Include the respective dates.
7. Finally, review the completed form for accuracy. Save your changes, and then download, print, or share the form as needed.

Complete your documents online to ensure your timely registration for Radiation Safety Training.