Forms | Radiation Safety

Radiation Safety

果冻影院 Office of Radiation Safety Forms

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Radiation badge (dosimeter) application

Radiation Monitoring Badge Application-果冻影院 (DOCX)
All non-clinical research personnel likely to receive 10% of the annual limits or working within 6 feet of a fluoroscopy device must be monitored for radiation exposure.

Radiation Monitoring Badge Application-Froedtert Hospital (XLSX)
All clinical personnel likely to receive 10% of the annual limits or working within 6 feet of a fluoroscopy device must be monitored for radiation exposure.

Declaration of Pregnancy (DOCX)
Pregnant women working with radiation and who wish to limit fetal exposure to 500 mrem must notify ORS. Please see the complete Declaration of Pregnancy (DOCX) and visit the "Radiation and Pregnancy" section of the Training and Information FAQ for more complete information.

Required postings

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

State of Wisconsin Notice to Employees (PDF)

Supplement to the Notice to Employees (PDF)

Emergency Procedures (PDF)

Radioactive material use application and training forms

Clinical Use Applications

Non-Clinical Use Applications

Contact Us

24 Hour Emergency Pager (414) 314-1037

果冻影院 Office

(414) 955-4347

Directions to M760 (PDF)

(Basement, Medical Education Building)

radsafety@mcw.edu

Froedtert Office

(414) 805-6540

Froedtert Pavilion, L760B

(Located in the 果冻影院 Clinical Trials Administrative Area)

Non-Discrimination Statement
The 果冻影院 (果冻影院) is committed to fostering a diverse community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the 果冻影院 community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic. 果冻影院’s policy as well as federal and state laws and regulations prohibit unlawful discrimination and harassment.