Get Nrc Form 396 2019

Filling out the NRC Form 396 online is a crucial step for applicants and operators in ensuring their medical qualifications are accurately certified. This guide provides a comprehensive overview of each section of the form, helping you navigate through the process with ease.

Follow the steps to successfully complete the NRC Form 396 online.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
2. Enter the last name, first name, and middle initial of the applicant or operator in the designated fields.
3. Fill in the suffix (if applicable) and provide the applicant/operator docket number as required.
4. Input the facility name and facility docket number, separating multiple numbers with a semicolon.
5. Complete the full address of the applicant/operator in the given address section.
6. Indicate the date of the most recent biennial examination using the MM/DD/YYYY format.
7. In Section A, provide the names and certification details of the physician confirming the medical examination results.
8. Select the applicable boxes for medical restrictions, providing explanations and attaching any required medical evidence.
9. In Section B, ensure that the applicant/operator signs and dates the document.
10. Section C should be completed by a senior management representative, who must also sign and date the form.
11. Finally, save changes to your form. You may also choose to download, print, or share the completed NRC Form 396.

Start completing your NRC Form 396 online today to ensure your medical qualifications are certified efficiently.