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This document is a reprint of NRC Form 396, used to certify the medical examination by facility licensee, which is pertinent to the licensing regulations of the Nuclear Regulatory Commission (NRC).
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How to fill out NRC Form 396

01
Obtain NRC Form 396 from the relevant authority or online.
02
Fill in your personal details, including your name and contact information.
03
Provide the required information about the equipment or material that is being reported.
04
Specify the purpose and scope of the application clearly.
05
Review all filled information for accuracy and completeness.
06
Sign and date the form as required.
07
Submit the form according to the submission guidelines provided.

Who needs NRC Form 396?

01
Individuals or organizations working with materials or equipment regulated by the NRC.
02
Entities seeking to apply for a specific license related to nuclear materials.
03
Researchers needing to report the use of certain radioactive substances.
04
Contractors or companies involved in the nuclear industry.
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NRC Form 396 is a document used by the Nuclear Regulatory Commission (NRC) in the United States for individuals who need to report their training and experience with radioactive materials.
Individuals who are seeking to obtain or renew licenses to work with radioactive materials or those applying for specific radiation-related positions are required to file NRC Form 396.
To fill out NRC Form 396, individuals should gather information on their training and experience with radioactive materials and complete the form with accurate details regarding their qualifications and any previously held licenses.
The purpose of NRC Form 396 is to ensure that individuals working with radioactive materials have appropriate training and experience, thereby promoting safety and regulatory compliance in handling such materials.
NRC Form 396 requires the reporting of personal information, training received, experience with radioactive materials, and details about any licenses held or previously held by the individual.
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