Radioactive Material Program (RAM) - Forms

General Forms

• Generic Radiation Protection Program
• Notice to Employees Form
• Occupational Dose - Annual Report
• Lifetime or Current Year Occupational Dose Form
• Regulatory Guides and Guidance
• Decayed Waste: Proper Safety Procedures
• Landlord Acknowledgement Form

Applications

• Amendment Request Form
• General License Registration Form (Click here to access our online system)
• In-Vitro General License Registration Form - Please call 775-687-7550 to request an application form
• Medical Use Radioactive Material License Application Form (Click here to access our online system)
• Radioactive Material Application Form (Click here to access our online system)
• Portable Gauge License Application Form (Click here to access our online system)
• Fixed Gauge License Application Form (Click here to access our online system)
• Nevada Reciprocity Application Form
• License Termination Form (Click here to access our online system)

License Application Guidance

• Guidance Checklist for Fixed Gauges
• Guidance Checklist for Portable Gauges
• Guidance Checklist for Medical Licensee
• Guidance Checklist for Radiopharmacy Licensee
• Guidance Checklist for Industrial Radiography
• Guidance Checklist for Irradiators
• Guidance Checklist for Accelerators - Cyclotrons
• Guidance Checklist for Laboratories
• Guidance Checklist for Veterinary Licensee
• Guidance Check List for Well Logging
• Well Logging Training Record

Preceptor Forms for Training and Experience

• Appendix D of NUREG 1556 Med rev 3 Guidance for filling out 313A Forms
• NRC Form 313A(AMP) - Authorized Medical Physicist
• NRC Form 313A(ANP) - Authorized Nuclear Pharmacist
• NRC Form 313A(AUD) - Authorized User 35.100, 35.200, 35.500 Uses
• NRC Form 313A(AUS) - Authorized User 35.400, 35.600 Uses
• NRC Form 313A(AUT) - Authorized User 35.300 Uses
• Gauge Authorized User Training Log
• NRC Form 313A(RSO) - Radiation Safety Officer
• RSO Delegation of Authority/Acceptance Form
• Non-RSO Delegation of Authority
• Training for Veterinary RSO/AU
• RSO Duties