UW RAM Shipment Request

All shipments of radioactive material will be performed by or with the direct oversight of EH&S's Radiation Safety team. EH&S must be notified prior to any shipment of radioactive material, either on or off campus. This ensures that all radioactive material is transported in accordance with all applicable regulations.

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.

Requestor First Name *

Requestor Last Name *

Requestor Email *

Requestor 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.

Company *

Worktag *

Fiscal Contact *

Box *

Fiscal Contact Email *

Shipment Description *

Isotope *

Activity (mCi) *

Physical (Solid, Liquid, Gas) *

Chemical Form (Sodium Iodide) *

Recipient Organization *

Recipient Name

Recipient Email

Recipient 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.

Handling Instructions

Delivery Date *

Month

Day

Year

Delivery Time

Hour

Minute

Additional Information