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Get the free NRC Form 396 Certification of Medical Examination By Facility Licensee - pbadupws nrc

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This document provides a revised form for the certification of medical examinations by facility licensees, in accordance with current operator licensing policy.
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How to fill out nrc form 396 certification

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How to fill out NRC Form 396 Certification of Medical Examination By Facility Licensee

01
Obtain NRC Form 396 from the NRC website or through your facility's regulatory office.
02
Complete the top section of the form with the individual's personal information (name, address, date of birth, etc.).
03
Enter the facility's information where the examination is taking place, including the facility license number.
04
Ensure that a qualified medical examiner completes the section detailing the medical examination results.
05
Include any required signatures from both the medical examiner and the facility's authorized representative.
06
Double-check all entered information for accuracy and completeness before submission.
07
Submit the completed NRC Form 396 to the appropriate regulatory authority or keep it on file as required by your facility.

Who needs NRC Form 396 Certification of Medical Examination By Facility Licensee?

01
Any individual who works in a position that requires access to nuclear materials or radiation.
02
Employees at licensed nuclear facilities who are designated to perform specific radiation-related duties.
03
Personnel in certain medical or industrial sectors involving radiation exposure.
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Exports or imports of nuclear commodities under the NRC licensing authority, which are not explicitly authorized under one of the aforementioned general export or general import license provisions, must first be approved by the NRC through the issuance of a specific license.
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NRC Form 396 is a document used to certify that an individual has undergone a medical examination and meets the medical requirements for working in facilities licensed by the Nuclear Regulatory Commission (NRC).
Facility licensees are required to file NRC Form 396 for individuals who are assigned to jobs that require unescorted access to areas where radioactive material is utilized or stored.
To fill out NRC Form 396, the facility licensee must complete sections detailing the individual's identification, medical examination results, and the licensee's authorization. Accurate documentation and signatures are necessary.
The purpose of NRC Form 396 is to ensure that individuals who have access to sensitive areas of a nuclear facility meet the health and safety standards set forth by the NRC, thus promoting a safe working environment.
NRC Form 396 must report the individual's name, date of birth, medical examination results, the date of the examination, the licensing facility information, and the certifying official's signature.
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