RDC Reassignment Badge Form

Radiation Badge Reassignment

This form is to be used when: An existing unused badge is worn by another person, or A blank/spare badge is assigned.
Company Name
Contact Name
RDC Account #
Group
Instructions: (Please read before completing form)

Enclosing this form with your blank/spare dosimeters will assist Radiation Detection Company (RDC) in assigning and reporting the results. All assignments need to be recorded on this form in order for the assigned identification to appear on your Dosimetry Report.
Name

Last NameFirst Name
DTN (6-7 alphanumeric characters on back of badge)*
YesNo
Assignment Code Meaning:

A - A one-time assignment for a one-time wearer without a PIN (YTD and lifetime doses will not be combined with previous reports.)
B - First assignment for a new user without a PIN
C - Assignment to a current, previous, or reactivated user
(YTD and lifetime doses will be combined with previous reports.)
Assignment Code*
Group #*
PIN (If Current, Previous, or Re-activate Wearer
Name (Actual Wearer)*

Last NameFirst Name
Gender
Date Of Birth
YesNo

Radiation Badge Reassignment