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This version of the form is not currently in use and is provided for reference only. Download this version of
NRC Form 396
for the current year.
NRC Form 396 Certification of Medical Examination by Facility Licensee
What Is NRC Form 396?
This is a legal form that was released by the U.S. Nuclear Regulatory Commission on June 1, 2021 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is NRC Form 396?
A: NRC Form 396 is a Certification of Medical Examination by Facility Licensee.
Q: What does NRC stand for?
A: NRC stands for Nuclear Regulatory Commission.
Q: Who uses NRC Form 396?
A: NRC Form 396 is used by facility licensees.
Q: What is the purpose of NRC Form 396?
A: The purpose of NRC Form 396 is to certify the results of a medical examination conducted by facility licensees.
Q: What information is included in NRC Form 396?
A: NRC Form 396 includes information about the licensee, the examined individual, the date of the examination, and the results of the examination.
Q: Is NRC Form 396 mandatory?
A: Yes, facility licensees are required to complete and submit NRC Form 396.
Q: Are there any fees associated with submitting NRC Form 396?
A: There are no fees associated with submitting NRC Form 396.
Form Details:
- Released on June 1, 2021;
- The latest available edition released by the U.S. Nuclear Regulatory Commission;
- Easy to use and ready to print;
- Yours to fill out and keep for your records;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of NRC Form 396 by clicking the link below or browse more documents and templates provided by the U.S. Nuclear Regulatory Commission.
Download NRC Form 396 Certification of Medical Examination by Facility Licensee
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