Accidental or unintended exposure to ionising radiation * 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the 'Undertaking and medical radiological installation details' section. Provide the name, address (including Eircode), email, and contact number of the undertaking, as well as the medical radiological installation name and address where the incident occurred.
3. In 'Section 1: Significant event details', specify the exact location of the incident, date and time it occurred, and when it was discovered. Indicate if multiple service users were affected and provide their details without including personally identifiable information.
4. Answer whether appropriate actions have been taken to mitigate recurrence of the incident. If yes, briefly describe these actions.
5. Select the significant event category from the provided options that best describes the incident. This helps categorize the nature of exposure accurately.
6. Complete 'Section 2: Dental/Radiology/Nuclear Medicine incident details' by estimating initial radiation doses involved in the incident.
7. Proceed to 'Section 3: Open Disclosure' to indicate if stakeholders have been informed about the incident.
8. In 'Section 4: Notification of stakeholders', check off any relevant parties that have been notified regarding this incident.
9. Finally, complete 'Section 6: Declaration' by printing your name, job title, contact number, signing in the designated field, and entering today's date before submitting your form via email.

Start using our platform today for free to streamline your document editing and submission process!