36.2 Forms #
To help authorized users stay in compliance with the rules and regulations regarding radioactive material, RSS provides a standardized program to document authorization to use radioactive materials or radiation-generating machines, record contamination surveys, distribute dosimeters, track radionuclides ordered and used, and ensure users have completed the required training.
Application Forms (RSS-101 Forms) #
Individuals who want to become authorized users of radioactive material must complete the following applications. The following forms may be in a downloadable “Word” format so that you can print them for your operation as is, or download and modify them to meet your unique needs. When you click the link it will automatically go to the download file.
Individuals wanting to use radioactive materials for animal research must also complete the RSS-101 Section 9 Form.
Contamination Surveys (RSS-105 Form) #
Authorized users and their lab personnel are responsible for conducting contamination surveys to verify the laboratory is free of radioactive contaminants, documenting and maintaining the contamination survey results, and having the contamination results available to RSS and the Nuclear Regulatory Commission inspectors. Use the following documents to conduct and record contamination surveys.
NOTE: Authorized users may record the results of the contamination survey on the Radioactive Contamination Survey Record or in their own log book.
Radionuclide Procurement and Tracking Form #
Authorized users are required to track each radionuclide purchased from time of purchase until the time of disposal. The Radionuclide Receipt, Utilization and Disposal Record Form can be used to track this information.
Training is required by state and federal regulations. Users of radioactive materials must take the Radiation Safety Orientation Course to acquaint them with any associated hazards.
In addition, each year after taking the Radiation Safety Orientation course, radioactive material users must take the Annual Refresher Training course to review radiological safety protocols and requirements. After completing the annual training, they must document that they have done so by signing the Annual Refresher Training Acknowledgment Form and filing it in the their authorized user’s Radiation Safety Manual and Records binder.
- Radiation Safety Orientation Course
- Radiation Safety for Health Care Workers (RADI-10115 on Cornerstone)
- Annual Refresher Training or download the Radionuclide Users Annual Refresher Training Guide
NOTE: Radioactive material users electing independent review must sign the Annual Refresher Training Acknowledgment Form attesting to having completed the independent review. Authorized users of radioactive materials must retain a copy of the signed acknowledgement sheet for inspection by RSS.
36.3 Customized Training #
RSS offers customized training for:
To schedule specialized training specific to your protocol, contact RSS at (734) 647-1143.
- X-ray devices and specialized equipment specific or unique to radiological use, such as:
- Analytical X-ray Machine Safety Training
- X-ray Fluoroscopy Safety Training
- Sealed-Source Safety Training
- Radiation Safety Training for Animal Handlers
- Specifically-required protocols for those individuals using radioactive materials or radiation-generating machines
