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Laser Use Permit Form 2009-2023
Media
Laser Media
Wavelength (nm)
Wavelength (nm)
Max. Energy (J)
or
Max Power (W)
Max. Energy (J)
or
Max Power (W)
Class
Use Type
3b
Human
4
Class
Non-human
Use Type
If Human Use,
List Medical
Procedures
If Human Use,
List Medical
Procedures
Use Location
Use Location
Laser Owner
(if not the PA)
Laser Owner
(if not the PA)
Number of CONTINUATION SHEETS attached
S:/RAD/wrd/LASER/PERMIT rev 050909.doc
3b
Human
4
Non-human
UTMB
APPLICATION FOR LASER USE PERMIT
EHS USE...
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