A dose history report for up to ten monitored individuals may be requested
by completing and submitting the form below and submitting a signed release
for each individual. Requesters must send a signed release form for each
monitored individual in order to receive a dose history report. All fields are
required to be completed except request comments. Upon approval of your request,
a dose history report in PDF format will be e-mailed to you. The PDF file will be
encrypted and password protected using the password you provide below.
If you are an organization requesting a dose history for individuals, use the
organization release form.
If you are a member of the public, or you are requesting your own dose history, use the
individual release form.