The U.S. Nuclear Regulatory Commission is in the process of rescinding or revising guidance and policies posted on this webpage in accordance with Executive Order 14151 Ending Radical and Wasteful Government DEI Programs and Preferencing, and Executive Order 14168 Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government. In the interim, any previously issued diversity, equity, inclusion, or gender-related guidance on this webpage should be considered rescinded that is inconsistent with these Executive Orders.

NRC Form 4 – Cumulative Occupational Dose History

Form Number: NRC Form 4
Form Title: Cumulative Occupational Dose History
Current Edition: 11-04-2024
Authority Directive or Regulation: 10 CFR Part 20
Form Status: Approved by OMB: 3150-0005, Expires: 07/31/2027
Special Instructions:

Instructions and additional information pertinent to the completion of this form are on Page 2 of the form.

For Questions:

E-mail: Terry.Brock@nrc.gov RES/DSA/RPB Senior Health Physicist

Telephone Number: (301) 415-1793

 

Page Last Reviewed/Updated Tuesday, November 19, 2024