Radiation Source Sheet

  • Fax: 1(855) 285-2226

    RADIATION SOURCE SHEET

    Dear Customer:

    Thank you for selecting Med-Pro Inc. as your dosimetry provider! In order to provide the best service we require information on the radiation sources and radiation work at your location. This information is used to verify you are receiving the best dosimeter for your monitoring needs and helps us make sure the proper correction factors are applied in the analysis of your dosimeters. A comparison of the analysis data with the client radiation source information is an important quality assurance step in our program.
  • If your account service is divided into multiple groups please use copies of this form to report the information for each group.

    Please check all that apply, or enter more specific information at the bottom.
    Note: If ring extremity is being used, please check the ring source by indicating only one major source.
  • Gamma:
  • Beta:
  • Note that very low energy beta particle sources (3H, 14C, etc.) cannot be detected.
  • Items listed below may require Track Etch dosimetry
    Density gauges:
  • Accelerator Photons: Please indicate energies utilized.
  • neutrons:energies: 
  • neutrons:energies: 
  • Neutron:
  • Med-Pro, Inc.
    sales@med-pro.net
    P.O. Box 11760
    Fort Lauderdale, FL 33339
    Fax 855.285.2226

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