Submit a Cumulative Occupational Exposure History Form or Occupational Exposure for a Monitoring Period Form

Each Licensee should complete forms in accordance with instructions provided on the form.

Radiation Control Program

The Details of Submit a Cumulative Occupational Exposure History Form or Occupational Exposure for a Monitoring Period Form

What you need for Submit a Cumulative Occupational Exposure History Form or Occupational Exposure for a Monitoring Period Form

Please submit a record of dose exposure or record of cumulative occupational exposure.

How to submit Submit a Cumulative Occupational Exposure History Form or Occupational Exposure for a Monitoring Period Form

Mail your completed and signed report to:

Massachusetts Department of Public Health
Radiation Control Program
Schrafft Center, Suite 1M2A
529 Main St.
Charlestown, MA 02129

You can download the Cumulative Occupational Exposure History and Occupational Exposure for a Monitoring Period forms below.

Fax your completed and signed report to (617) 242-3457.

You can download the Cumulative Occupational Exposure History and Occupational Exposure for a Monitoring Period forms below.

Downloads for Submit a Cumulative Occupational Exposure History Form or Occupational Exposure for a Monitoring Period Form

Contact for Submit a Cumulative Occupational Exposure History Form or Occupational Exposure for a Monitoring Period Form

Address
Schrafft Center
529 Main St., Suite 1M2A, Charlestown, MA 02129
Fax
(617) 242-3457
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