American Board of Radiology - Program Director Attestation

COMPLIANCE WITH NRC TRAINING AND EXPERIENCE REQUIREMENTS


More information can be found at the following link:
http://www.nrc.gov/reading-rm/doc-collections/cfr/part035/part035-0290.html



______________________    ______________________    ______________________
Resident Name Program Program #        
    Yes   No
By the time of the ABR oral examination, this applicant will have successfully completed 700 hours of training and experiences as outlined in 10 CFR 35.290   _____   _____
 
This applicant has taken part in 3 or more cases of I-131 therapy(33MCi or less).   _____   _____
 
The resident's logbook of these therapy experiences (date, dose, preceptor) is attached.   _____   _____
 
All the training and experience cited above was obtained under the supervision of an authorized user who meets the requirements under § 35.290 and relevant sections of § 35.390 or equivalent Agreement State Requirements   _____   _____


______________________    ______________________    ______________________  
Residency Program Director   
(Print Name)
Program Director   
(Signature)
Date