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INDIVIDUAL RADIATION EXPOSURE HISTORY DATA SHEET

INDIVIDUAL RADIATION EXPOSURE HISTORY DATA SHEET 2026

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The document is a Radiation Safety Individual Radiation Exposure History Data Sheet from the University of Georgia, revised on December 14, 2015. It collects personal information and radiation exposure history for individuals monitored for occupational radiation exposure. The form includes sections for current and lifetime radiation exposure, authorization for record release, and emphasizes confidentiality in handling the information.

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Click ‘Get Form’ to open the INDIVIDUAL RADIATION EXPOSURE HISTORY DATA SHEET in the editor.
Begin by entering your Last Name, Middle Initial, First Name, and UGA ID Number in the designated fields.
Respond to the first question regarding occupational radiation exposure monitoring for the current calendar year by selecting 'Yes' or 'No'. If 'Yes', provide your radiation exposure in millirem in the space provided.
If you have records of your radiation exposure, attach copies directly within the editor. If you do not know your exposure, list the organization where you were monitored along with its address and contact details.
For past monitoring, answer whether you have ever been monitored for occupational radiation exposure. If 'Yes', enter your lifetime annual radiation exposure (estimates are acceptable) excluding the current year.
Finally, sign and date the form to certify that all information is accurate. Ensure that you understand that this information is confidential and will be used for tracking purposes only.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do they test for radiation exposure?

A radionuclide screen is a collection of clinical lab tests used to detect the presence of radiation-emitting isotopes in . Its purpose is to detect samples with radioactivity, provide data for radiation exposure assessment, and inform about an individuals health risk.

Who monitors radiation levels?

EPAs RadNet system monitors the nations air, ambient exposure rates, precipitation and drinking water for radiation.

What device is used to monitor radiation exposure?

A radiation dosimeter or badge does not provide protection but detects and measures radiation that you have been exposed to. The badge will detect high-energy beta, gamma or x-ray radiation. Dosimeters cannot detect low energy beta radiation from some isotopes, including carbon-14, tritium or sulfur-35.

How is radiation exposure controlled?

Time, Distance and Shielding Distance: Just as the heat from a fire reduces as you move further away, the dose of radiation decreases dramatically as you increase your distance from the source. Shielding: Barriers of lead, concrete, or water provide protection from penetrating gamma rays.

How is radiation exposure monitored?

How is Radiation Exposure to Staff Monitored? Staff monitoring is achieved by providing all workers with their own personal radiation monitoring badges, rings, and/or eye dosimeters to wear for a set period of time.

What is a radiation report?

These services include radiation dose measurements for persons who enter areas where they may be exposed to radiation or radioactive material. The results are periodically reported to monitored individuals.

INDIVIDUAL RADIATION EXPOSURE HISTORY DATA SHEET 2026

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