396 2019-2025 Form

What is the NRC Form 396 Certification of Medical Examination by Facility Licensee

The NRC Form 396 is a certification document required by the Nuclear Regulatory Commission (NRC) for individuals who are undergoing medical examinations related to their fitness for duty in nuclear facilities. This form serves to verify that the individual has met specific medical standards necessary for their role. The certification is crucial for ensuring safety and compliance within the nuclear industry, as it helps to assess the physical and mental health of personnel who may be exposed to hazardous materials or environments.

How to use the NRC Form 396 Certification of Medical Examination by Facility Licensee

Using the NRC Form 396 involves several key steps to ensure proper completion and submission. First, the individual needing the examination must schedule an appointment with a qualified medical examiner. During the examination, the medical examiner will assess the individual's health and determine their fitness for duty. After the examination, the medical examiner completes the NRC Form 396, detailing the findings and certifying the individual's medical status. It is important to ensure that all sections of the form are filled out accurately to avoid delays in processing.

Steps to complete the NRC Form 396 Certification of Medical Examination by Facility Licensee

Completing the NRC Form 396 involves a systematic approach to ensure all necessary information is provided. The steps include:

• Schedule a medical examination with an NRC-approved medical examiner.
• Undergo the medical examination, which may include physical tests, medical history review, and mental health assessments.
• The medical examiner fills out the NRC Form 396, including personal details, examination results, and any recommendations.
• Review the completed form for accuracy and completeness.
• Submit the form to the appropriate authority, as specified by the NRC or the employing organization.

Legal use of the NRC Form 396 Certification of Medical Examination by Facility Licensee

The NRC Form 396 is legally binding when completed and submitted according to regulatory standards. It is essential that both the medical examiner and the individual being examined understand the legal implications of the certification. The form must be filled out truthfully, as any false information can lead to penalties or disciplinary actions. Compliance with the NRC regulations ensures that the certification is recognized in legal contexts, safeguarding the health and safety of personnel in nuclear facilities.

Key elements of the NRC Form 396 Certification of Medical Examination by Facility Licensee

The NRC Form 396 includes several critical elements that must be addressed for it to be valid. These include:

• Personal identification details of the individual being examined.
• Medical history and any relevant prior medical conditions.
• Results of the medical examination, including physical and psychological assessments.
• Certification statement by the medical examiner, confirming the individual's fitness for duty.
• Signature of both the individual and the medical examiner, along with the date of completion.

Who Issues the NRC Form 396 Certification of Medical Examination by Facility Licensee

The NRC Form 396 is issued by the Nuclear Regulatory Commission, which oversees the use of this form within the nuclear industry. Medical examiners who are approved by the NRC are responsible for completing the form after conducting the necessary medical evaluations. It is crucial for individuals to ensure that their medical examiner is recognized by the NRC to maintain the validity of the certification.