|
Description of Form / Publication
|
File Format(s)
|
|
APPLICATIONS
AND FORMS
|
|
APPLICATIONS FOR ALL SPECIFIC LICENSEES
|
|
Notice
to all Radioactive Materials Licensees: Effective June 1st, 2016, all
licensees possessing quantities of radioactive materials equal to or
greater than that shown in Table 1 of Appendix A to 10 CFR Part 37 are
responsible for complying with the provisions of 10A NCAC 15 .1700. Please
direct any inquiries regarding this requirement to the Security
Coordinator.
|
|
Application
for Radioactive Materials License
|
|
|
|
Application
for Accelerator License
|
|
|
|
Application
for Amendment of Radioactive Materials and Accelerator Licenses
|
|
|
|
MEDICAL USE OF MATERIAL AND
ACCELERATORS
|
|
Preceptor Statements to add/change/delete Authorized Users on Medical
Licenses:
|
|
|
|
Unsealed
radioactive material for Diagnostic use (10 CFR 35 .100 and .200) (uptake,
dilution, and excretion studies, and imaging and localization studies)
|
Click Here
|
|
Unsealed
radioactive material for Therapeutic use (10 CFR 35 .392, .394, .396)
(applications requiring a written directive, radioiodine use, and
parenteral administration)
|
Click Here
|
|
Sealed
Source radioactive material for Therapeutic use (10 CFR 35 .400 and .600)
(brachytherapy, Sr-90 opthalmic use, remote afterloader, teletherapy and gamma stereotactic
radiosurgery) Notice to Accelerator Licensees: list accelerators in place of teletherapy units and use the form to document
experience using accelerators.
|
Click Here
|
|
Radiation
Safety Officer Notice to Accelerator Licensees: list relevant
accelerator-use experience in place of experience using teletherapy units.
|
Click Here
|
|
Authorized
Medical Physicist Notice to Accelerator Licensees: list accelerators in
place of teletherapy units and list relevant experience using accelerators
in place of experience using teletherapy units.
|
Click Here
|
|
Authorized
Radiopharmacist (Nuclear Pharmacist)
|
Click Here
|
|
Medical
Users Toolkit (NRC Guidance for Medical Users)
|
Click Here
|
|
|
NRC
Regulatory Guide 8.39 "Release of Patients Administered Radioactive
Materials"
|
Click Here
|
|
|
Medical
Event Reporting Form
|
|
|
|
Dose
to an Embryo/Fetus or Nursing Child Reporting Form
|
|
|
|
GENERAL FORMS AND GUIDANCE DOCUMENTS FOR ALL LICENSEES
|
|
Certificate of Disposition of Radioactive Materials (you can also
use NRC Form 314)
|
|
|
|
Financial
Assurance
|
Click Here
|
|
|
Radiographic
and Reciprocity Location report
|
Click Here
|
|
|
Memorandum
to All Licensees
|
|
|
|
Delegation
of Authority to RSO
|
|
|
|
Guidance
on Change of Control of Ownership
|
|
|
|
Occupational
Dose Record for a Monitoring Period
|
Click Here
|
|
|
Notice to Employees English
|
|
|
|
Notice to Employees Spanish
|
|
|
|
LICENSING GUIDANCE
|
|
NRC
Licensing Guidance for all Radioactive Materials Licensees
|
Click
Here
|
|
|
Application
Guide for a Medical Accelerator License
|
|
|
|
DOT EXEMPTIONS
|
|
Scrap
Metal and Municipal Waste containing unknown quantities of radioactive
material
|
|
|
|
|
|
 Top of Page
|
|
