Radiation Detection Instrument Registration

Complete this form to register your radiation detection instrument with EH&S's Radiation Safety Office at the UW. The information is used to maintain calibration records for all radiation detection instruments that are in use under the UW's Radioactive Materials License.

All radiation detection instruments must be registered with EH&S's Radiation Safety Office, even though they may be calibrated at any qualified facility.

The University of Washington is committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities. Contact the Environmental Health & Safety Department at ehsdept@uw.edu or call (206) 543-7262 to request an accommodation.

Fields marked with an asterisk ( * ) are required.

Contact Information

First Name *

Last Name *

Email *

Department *

UW Box # *

Phone # *

Please enter a valid ten-digit phone number with optional extension (e.g (206) 543-7262). Phone numbers should only contain numbers and + and - and ( and ) and spaces.

Owner Information

Name *

UW Box # *

Instrument Storage

Other Users?

Instrument Information

Manufacturer

Model Number

Serial Number

Characteristic

Radiation Detection Instrument Registration

Contact Information

Owner Information

Instrument Information

Additional Information