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> NRC Form 396 - Certification of Medical Examination by Facility Licensee
NRC Form 396 - Certification of Medical Examination by Facility Licensee
Form Number: | NRC Form 396 (With Instruction) | NRC Form 396 (Without Instruction) |
Form Title: | Certification of Medical Examination by Facility Licensee |
Current Edition: | 05-2012 |
Authority Directive or Regulation: | |
Form Status: | Approved by OMB: 3150-0024, Expires: 04/30/2015 |
Special Instructions: | Instructions are on Page 2 of the form. NRC Form 396, "Certification of Medical Examination by Facility Licensee," must accompany the NRC Form 398 unless a waiver of the medical examination is being requested. |
Page Last Reviewed/Updated Tuesday, May 15, 2012