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Office of Radiation Safety Declaration of Pregnancy PROCEDURE: EFFECTIVE DATE:ORS SOP1 07/18/2019REVISION DATES: PAGE NO:Page 1 of 41.0 Purpose 1.1 This procedure outlines the process for radiation
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How to fill out radiation staff pregnancy declaration

01
Obtain the radiation staff pregnancy declaration form from the appropriate authority or department.
02
Fill out your personal information, such as name, employee ID, and contact details, in the designated fields.
03
Provide details about your current radiation exposure levels, including the type and amount of radiation you are regularly exposed to.
04
Declare your pregnancy by indicating the date of conception or estimated due date.
05
State any accommodations or modifications you require during your pregnancy to ensure your safety and the safety of your unborn child.
06
Sign and date the declaration form to certify the accuracy and truthfulness of the information provided.
07
Submit the completed declaration form to the relevant authority or department as instructed.

Who needs radiation staff pregnancy declaration?

01
Radiation staff, especially those who are pregnant or planning to become pregnant, need to fill out the radiation staff pregnancy declaration. This helps ensure the necessary precautions and accommodations are taken to protect both the mother and the unborn child from any potential risks associated with radiation exposure.
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Radiation staff pregnancy declaration is a form that needs to be submitted to report pregnancy status of staff members who work with radiation.
Radiation staff who are pregnant or who become pregnant while working with radiation are required to file the declaration.
The declaration can be filled out by providing personal information, pregnancy status, and radiation exposure details.
The purpose of the declaration is to ensure the safety of pregnant radiation staff and their unborn child by implementing necessary precautions.
Information such as name, department, job title, pregnancy status, date of conception, radiation exposure details, and recommended precautions must be reported.
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