The NRC is modernizing nrc.gov with an updated design and improved navigation to enhance usability. We are committed to a smooth transition and will work to minimize any disruption. The site may be briefly unavailable at times during launch. Thank you for your patience.
NRC Form 5 – Occupational Dose Record for a Monitoring Period
| Form Number: | NRC Form 5 |
|---|---|
| Form Title: | Occupational Dose Record for a Monitoring Period |
| Current Edition: | 11-18-2024 |
| Authority Directive or Regulation: | 10 CFR Part 20 |
| Form Status: | Approved by OMB: 3150-0006, Expires: 11/30/2024 |
| 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, August 11, 2026
Page Last Reviewed/Updated Tuesday, August 11, 2026