F2067 2026

1. Click ‘Get Form’ to open the f2067 in the editor.
2. 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.
3. Next, provide the employee's information. Fill in their surname, forenames, permanent address (including postcode), date of birth, sex, and National Insurance number.
4. Indicate the date of commencement as a classified person in this employment and describe the nature of employment.
5. 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.
6. Complete details for the Approved Dosimetry Service responsible for maintaining the employee’s dose record by entering their name and address.
7. 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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