University of Vermont

Radiation Safety Office

Exposure Report Request Form

This form is for UVM personnel only.

Please use the following form to submit a request to the RSO if you would like to know your monthly exposure information.

Your Name:
E-mail Address:
Phone Number:
Request exposure information for the year & month: 
Any other information or monthly exposures that you would like to receive from the RSO?
How would you like to be contacted with this informations?