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University of Nebraska Medical CenterNebraska Medicine  Form

University of Nebraska Medical CenterNebraska Medicine Form

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180 NAC 4-012 10 CFR Part 20. 1208 I understand that my exposure will not be allowed to exceed 5 mSv 500 mrem during my entire pregnancy from occupational exposure to radiation. I understand that this limit includes exposure I have already received. If my estimated exposure since the above date of conception has already exceeded 4. If I should find out that I am not pregnant or if my pregnancy is terminated I will inform my immediate supervisor as soon as practical. Signature Date Department...
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