Forms

Language

Person's registration

Temporarily suspend dosemeter shipping

Cancel individual dosemeters

Change of name

Person sign off

scheduling

start (month/year)*

end (month/year)* end (month/year)*

undefinite

company

company number (on dosemeter)*

name of the company*

city of enterprise*

personal details

person number (on dosemeter)*

academic title

name* surname (to date)*

first name* first name (to date)*

single name

social insurance number*

unknown

date of birth* [DD.MM.YYYY]

sex sex

nationality

personal details (new)

surname (new)*

first name (new)*

dosemeter*

whole body:

standard

over apron

with thyroid protection*

without thyroid protection*

fingerring / extremities:

others:

exposed for the first time?*

yes

No, previous doses are available

protective garments* check at least 1 box

lead apron

thyroid shield

leaded gloves

protective glasses

none

profession*

physician

MTRA, TRM

medical physicist

med. practice assist. (MPA)

nurse

operating room technician

technical staff

scientific staff

laboratory technician

chiropractor

dentist

dental assistant (DA)

dental assistant (DH)

veterinarian

veterinary practice assistant

miscellaneous

category*

Radiological Protection Ordinance

Category A

Category B

activities*

medicine

gynaecology

diagnostic radiology

pediatrics

interventional radiology

rheumatology

angiology

dermatology

surgery

ORL (HNO)

gastroenterology

chiropractic

cardiology

technics

orthopaedics

laboratory

pain therapy

dentistry

urology

veterinary medicine

radiotherapy

education

nuklear medicine

research

general medicine

internal medicine

radiation sources*

radiography

fluoroscopy

CT

PET

cyclotron

linear accelerator

sealed source

unsealed source

isotope generator

nuclear reactor

radioactive waste

contact person

name*

first name*

phone number for inquiry call*

Staff modification