F2067 2026

The document outlines the requirements for maintaining health records related to ionising radiation exposure in the workplace, as mandated by the Health and Safety at Work etc Act 1974 and Ionising Radiations Regulations 1999. It includes sections for employer and employee details, assessments of female employees' radiation exposure, and medical evaluations by appointed doctors. The health record must be preserved for a minimum of 50 years or until the individual reaches 75 years of age.

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Click ‘Get Form’ to open the f2067 in the editor.
Begin with Part A, where the employer must fill in their details. Enter the name and address of the employer, ensuring to include the postcode.
Next, provide the employee's information. Fill in their surname, forenames, permanent address (including postcode), date of birth, sex, and National Insurance number.
Indicate the date of commencement as a classified person in this employment and describe the nature of employment.
For female employees, answer whether they are likely to receive an equivalent dose of ionising radiations exceeding 13mSv in any consecutive period of 3 months for each specified year. Ensure to consult a Radiation Protection Adviser if needed.
Complete details for the Approved Dosimetry Service responsible for maintaining the employee’s dose record by entering their name and address.
In Part B, an HSE Appointed Doctor or Employment Medical Adviser must fill out assessment details including date, type of assessment, result, conditions imposed, expiry date of certification, and their signature.

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