Radiation Safety
Radiation Safety Electronic Forms
You must return your completed application (form) to our office for review and approval!
- Declaration of Pregnancy Form (word | PDF)
- "Notice To Employees - NRC Form 3" (PDF)
- NRC Regulatory Guide 8.29 (PDF)
- Dosimeter Application:
- Online submission of the Dosimeter Application can be done here. (NEW! 12/27/2012)
- Download and print Dosimeter Application. Completed form MUST be signed and then sent via messenger mail to P.O. Box 400322, download word or PDF form.
- Principal Investigator Application (word | PDF)
- Authorized User Application (word | PDF)
- Qualified User Application (word | PDF)
- General User Application (word | PDF)
- Irradiator Use Application - contact Environmental Health & Safety at 982-4911
- Authorization Amendment Form (word | PDF)
- Radioisotope Survey Sheet (word | PDF)
- Radioisotope Inventory Log Sheet (word | PDF)
Authorizations
- Principal Investigator & Qualified User Applications must be signed by an existing Principal Investigator (PI) who serves as a sponsor for the person making the application. For the Qualified User, the application must be signed by the applicant's PI. The application will be reviewed by the Radiation Safety Officer, Alternate RSO and two members of the RSC. If approved during this initial review, the Chairman of the RSC will approve the application.
- Authorized User Applications (along with a preceptor statement) must be submitted to EHS to document that the individual meets the training criteria specified in Part 35. The application must be approved and the individual must be designated an Authorized User by the Radiation Safety Committee.
- General User Applications must be signed by the applicant's PI or AU. The application is reviewed by the RSO or Alternate RSO, and if approved, is sent to the Chairman of the RSC for final approval.
Radiation Safety Committee Letter of Approval
Environmental Health & Safety will review all applications for completeness and ensure that the necessary training requirements have been met. The RSO and/or RSC must approve all applications.
Upon approval of your application, you will receive a letter from the Chairman of the RSC authorizing you to work with radioactive material or radiation producing equipment at the University of Virginia. You are encouraged to use Environmental & Safety as a resource. If you have any questions regarding the use of radioactive material or radiation producing equipment, please feel free to contact our office at 982-4911.