P. 1
Exposure Question a Ire

Exposure Question a Ire

|Views: 0|Likes:
Published by senorafiore9517

More info:

Published by: senorafiore9517 on Nov 13, 2010
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as DOC, PDF, TXT or read online from Scribd
See more
See less

05/12/2014

pdf

text

original

EXPOSURE QUESTIONAIRE

1. Was the badge placed or stored near radiation?

2. Did you accidentally expose yourself to a beam of increased radiation?

3. Did you hold a patient during radiation exposure?

4. Did you work significantly more hours or procedures during this period?

5. Where you involved in procedures requiring unusually high exposure to radiation?

Please describe any unusual incident or provide any additional information that might help explain your dose.

Print Name:

Signature

Date

Department

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->