Forms

Lab/Personnel Forms 

• Badge Application

• Pregnancy Declaration

• Lab Worker Registration

• Survey Meter Registration

• Radioactive Material Transfer Request 

• Laboratory Closeout Notice

• Laboratory Closeout Checklist

Radiation Producing Device

• Radiation Producing Device Registration

• Radiation Producing Device Modification

• Radiation Producing Device Service/Repair

Waste Forms

• Waste Pickup Request

• Radioactive Waste Composition Record (1-5 Gal)

• Radioactive Waste Composition Record (30-50 Gal)

• Uranium and Thorium Financial Assurance Waste Form

ARU/PI Human Use Applications

• For uses under 10 CFR 35.100, 35.200, and 35.500

• For uses under 10 CFR 35.300

• For uses under 10 CFR 35.400 and 35.600

• For uses under 10 CFR 35.1000 Yttrium-90 Microspheres

• For uses under 10 CFR 35.1000 Radioactive Seed Localization

AMP Human Use Application

• AMP application for uses under 10 CFR 35.400 and 35.600

ARU/PI Non-human Use Application

• ARU/PI Non-Human Use Application

NRC 313A Forms

• Authorized Medical Physicist Training and Experience and Preceptor Attestation (for uses under 35.51) - NRC Form 313a(amp)

• Authorized User Training and Experience and Preceptor Attestation (for uses under 35.100, 35.200, and 35.500) - NRC Form 313a(aud)

• Authorized User Training and Experience and Preceptor Attestation (for use under 35.300) - NRC Form 313a(aut)

• Authorized User Training and Experience and Preceptor Attestation (for uses under 35.400 and 35.600) - NRC Form 313a(aus)

Additional NRC Licensing Guidance

• Licensing guidance for Yttrium-90 Microspheres

• Licensing guidance for Radioactive Seed Localization

• Licensing guidance for Gamma Knife 35.1000

NRC Links

• Specialty Board(s) Certification Recognized by NRC under 10 CFR Part 35

• NRC 10 CFR Part 35

Signage

• NRC Form 3 "Notice to Employees" (9.2024)

• WV RHP Form X "Notice to Employees"

• WVU Radiation Safety Emergency Procedures