» Marshall University Radiation Safety Forms
Instructions: Fill out form using Microsoft Word and email as an attachment to mccumbee@marshall.edu. Fields requiring a signature from the RSO are marked in red and should be disregarded. Any required attachments (such as floor plans) should be sent as an attachment in an email to mccumbee@marshall.edu alongside the corresponding form.
Form 1-A Application for Use of Radioisotopes
Form 1-B Statement of Training and Experience
Form 1-C Radiation Equipment
Form 2 Request for Use of Radioisotopes in Animals or Plants
Form 3 Radioactive Material Shipment Receipt Report
Form 4-A Records of Dose-Rate Survey and Report
Form 4-B Records of Contamination Survey and Report
Form 5-A Quarterly Radioisotope Report
Form 5-B Quarterly Radioisotope Report
Form 6 Radioactive Disposal Form (Must be submitted with Quarterly Isotope Report)
Form 7 Exposure History Release Form
Form 8 Radiation Exposure Report
Form 9-A Leaktest Activity Measurement
Form 9 Certification of Leak Test
Form 10 Record of Thyroid Scan/Bioassay
Form 11 Transfer of Radioactive Materials