Radiation Dosimeter

All students must complete the Radiation Dosimeter form as a part of the clinical practicum paperwork. Please download and complete the Radiation Dosimeter Form at least six weeks prior to your clinical practicum. Once you download the form, complete it fully and press submit. You will be prompted that the form is trying to send the form to RAIS@bellevuecollege.edu. Please allow this and follow the instructions provided by your PDF reader software.

Alternatively, you may save the completed form to your desktop and email it directly to RAIS@bellevuecollege.edu.

Things to keep in mind

  • Students in CT, PET, Mammo, and VIR students may use a dosimeter provided by their clinical site but MUST complete this form to indicate they are being provided a dosimeter.
  • Students will receive their dosimeter via the mailing address provided on the dosimeter form.
  • Students will mail or hand deliver the dosimeter to the Radiation & Imaging Sciences Program within 5 business days of the completion of the clinical practicum.
  • Students will be charged a nonrefundable Non-Return Charge $25 if the dosimeter is lost not returned to the Radiation & Imaging Sciences program.
  • Clinical Practicum course grades may be withheld if the dosimeter is not return the dosimeter by 5th business day following the completion of the clinical practicum.
  • Students must put “Do not x-ray; radiation monitor inside.” on return envelope if the dosimeter is returned by mail.

Last Updated December 8, 2021