Get the free Dosimeter Request Form - ehs ucr
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Dosimeter Request Form
Instructions: Use this form to request a Dosimeter / Badge from Radiation Safety. All fields are
required to be completed.
1. Last Name2. First Name3. Email4. Birthdate (MM/DD/YYY)5.
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How to fill out dosimeter request form
How to fill out dosimeter request form
01
Obtain the dosimeter request form from the appropriate department or supervisor.
02
Fill out your personal information including name, employee ID, and contact information.
03
Indicate the type of dosimeter needed (e.g. radiation or chemical exposure).
04
Specify the duration for which the dosimeter is needed.
05
Sign and date the form to certify the information provided.
06
Submit the completed form to the designated person or department for processing.
Who needs dosimeter request form?
01
Employees who work in environments where they may be exposed to radiation or chemicals.
02
Researchers conducting experiments involving hazardous materials.
03
Industrial workers in sectors such as nuclear power, healthcare, and manufacturing.
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What is dosimeter request form?
The dosimeter request form is a document used to request a dosimeter for measuring radiation exposure.
Who is required to file dosimeter request form?
Employees who are exposed to radiation in their workplace are required to file a dosimeter request form.
How to fill out dosimeter request form?
To fill out a dosimeter request form, employees need to provide their personal information, job title, workplace details, and any relevant exposure history.
What is the purpose of dosimeter request form?
The purpose of the dosimeter request form is to monitor and track radiation exposure levels for employees working in radiation-prone environments.
What information must be reported on dosimeter request form?
The dosimeter request form must include employee's personal details, job title, workplace address, and any relevant exposure history.
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