Radiation Safety Forms for Researchers

• In the right place? If you work in a clinical environment, use Radiation Safety Forms: Health System Employees.

Use the forms below if you are a researcher working with radioisotopes.

Radioisotope Use Authorization

• Radioisotope Use Authorization Application (PDF)
• Radioisotope Use Authorization Application (Sealed Source Only) (PDF)
• Radioisotope Use Authorization Amendment

Note: RUA applications must be received 1 week prior to the Radiation Safety Committee (RSC) meeting on the 2nd Tuesday of every other month (starting in January). Otherwise, applications will be deferred until the next regularly scheduled RSC meeting.

User Enrollment/ Cancellation

• Researchers Using Unsealed Radioisotopes 
• Researchers Using Sealed Radioisotopes 
• Cancellation (Remove personnel from your RUA/MUA or to cancel dosimetry service)
• See Radiation-Producing Machines below for user enrollment and cancellation forms.

Monitoring Radiation Exposure

• Declaration of Pregnancy
• Iodination Log (PDF)
• Laboratory Meter Survey Record (PDF)
• Laboratory Survey Sheet (PDF)
• Request for Replacement Dosimeter

Delivery and Transfer of Radioactive Materials

• Radioactive Materials Package Delivery Request  
• Transfer of Radioactive Material - Intracampus (PDF)
• Transfer of Radioactive Material - Off-Campus (PDF) 

Lab and Equipment Clearance

• Equipment and Facility Decontamination Clearance Request
• Laboratory Relocation or Closure Notification

Radiation-Producing Machines

• Enrollment for Researchers Using Radiation-Producing Machines 
• Machine Use Registration (PDF)
• Machine Registration Amendment (PDF)
• Cancellation