NRC Form 396 Certification of Medical Examination by Facility Licensee

Notification Icon This version of the form is not currently in use and is provided for reference only. Download this version of NRC Form 396 for the current year.

NRC Form 396 Certification of Medical Examination by Facility Licensee

What Is NRC Form 396?

This is a legal form that was released by the U.S. Nuclear Regulatory Commission on January 1, 2018 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is NRC Form 396?A: NRC Form 396 is the Certification of Medical Examination by Facility Licensee.

Q: Who is responsible for completing NRC Form 396?A: The facility licensee is responsible for completing NRC Form 396.

Q: What is the purpose of NRC Form 396?A: The purpose of NRC Form 396 is to certify the results of a medical examination conducted by the facility licensee.

Q: What does the NRC Form 396 include?A: NRC Form 396 includes information about the licensee, the examined individual, the date of the examination, and the signature of the examining physician.

Q: Is NRC Form 396 required by law?A: Yes, NRC Form 396 is required by law for certain individuals who require medical examinations as part of their nuclear facility licensing requirements.

Q: Can NRC Form 396 be completed electronically?A: Yes, NRC Form 396 can be completed electronically if allowed by the NRC.

Q: Are there any fees associated with submitting NRC Form 396?A: There may be fees associated with submitting NRC Form 396, depending on the specific licensing requirements and regulations.

Q: What should I do if I have questions about completing NRC Form 396?A: If you have questions about completing NRC Form 396, you should contact the Nuclear Regulatory Commission (NRC) for guidance.

ADVERTISEMENT

Form Details:

  • Released on January 1, 2018;
  • The latest available edition released by the U.S. Nuclear Regulatory Commission;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of NRC Form 396 by clicking the link below or browse more documents and templates provided by the U.S. Nuclear Regulatory Commission.

Download NRC Form 396 Certification of Medical Examination by Facility Licensee

4.3 of 5 (39 votes)
  • NRC Form 396 Certification of Medical Examination by Facility Licensee

    1

  • NRC Form 396 Certification of Medical Examination by Facility Licensee, Page 2

    2

  • NRC Form 396 Certification of Medical Examination by Facility Licensee, Page 3

    3

  • NRC Form 396 Certification of Medical Examination by Facility Licensee, Page 1
  • NRC Form 396 Certification of Medical Examination by Facility Licensee, Page 2
  • NRC Form 396 Certification of Medical Examination by Facility Licensee, Page 3
Prev 1 2 3 Next
ADVERTISEMENT