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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 January 3, 2023 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: Who is required to complete NRC Form 396?
A: Facility licensees are required to complete NRC Form 396.
Q: What is the purpose of NRC Form 396?
A: The purpose of NRC Form 396 is to certify the medical examination of individuals working in nuclear facilities.
Q: What information is included in NRC Form 396?
A: NRC Form 396 includes information such as the name of the licensee, the name of the facility, and the date of the medical examination.
Q: When is NRC Form 396 required to be filed?
A: NRC Form 396 is required to be filed within 30 days of the medical examination.
Q: Are there any fees associated with filing NRC Form 396?
A: No, there are no fees associated with filing NRC Form 396.
Q: Can NRC Form 396 be filed electronically?
A: Yes, NRC Form 396 can be filed electronically through the NRC's electronic filing system.
Q: What happens if NRC Form 396 is not filed?
A: Failure to file NRC Form 396 may result in non-compliance with NRC regulations and potential penalties.
Form Details:
- Released on January 3, 2023;
- 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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