Office of Radiation Safety Forms


Radioactive Material Use Application and Training Forms

Click here for the complete Radioactive Material Use Authorization page, including Application and Amendment Forms.

Gamma Knife/Irradiator Access Forms (MCW network access only)

 

Film Badge (Dosimeter) Application

Film Badge Application-MCW (DOC)
All non-clinical research personnel likely to receive 10% of the annual limits must be monitored for radiation exposure.

Film Badge Application-FH (DOC)
All clinical personnel likely to receive 10% of the annual limits must be monitored for radiation exposure.

Declaration of Pregnancy (PDF)
Pregnant women working with radiation and wish to limit fetal exposure to 500 mrem must notify ORS. Please see the complete Radiation and Pregnancy page for more complete information.


Inventory and Disposal Forms

Sewer Disposal Log (PDF)
For labs who dispose of radioactive aqueous liquids in a designated sink in the lab. Includes instructions and monthly sewer disposal limits.

Scintillation Vial Log (PDF)
For labs disposing of bulk H-3 and C-14 scintillation vials.

Required Postings 

These PDFs should be printed and placed in areas where radioactive material is used or stored.

State of Wisconsin Notice to Employees

Supplement to the Notice to Employees

Emergency Procedures

Contact Us

MCW Offices M0760 (basement, Medical Education Building)
414-955-4347
Rad Safety@mcw.edu

Froedtert Offices Froedtert Pavilion, L760B (in the Women's Health Initiative Clinic area)
414-805-6540

Medical College of Wisconsin
8701 Watertown Plank Road
Milwaukee, WI 53226
(414) 955-8296
Directions & Maps
© 2014

Page Updated 10/31/2014
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