Templates
Radiation safety program template

Radiation safety program template

Stay on top of compliance, safety checks, and staff responsibilities with this template. You’ll get a clear structure for documenting sources, protection measures, and audit readiness.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
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Learn more
or Download template as PDF
Radiation safety program template

Stay on top of compliance, safety checks, and staff responsibilities with this template. You’ll get a clear structure for documenting sources, protection measures, and audit readiness.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

Developed for radiation safety officers and facility managers, this radiation safety program template offers a systematic approach to radiation protection compliance. It includes sections for organizational structure, monitoring protocols, training requirements, and emergency response procedures—all essential for maintaining regulatory compliance. When facing audits or implementing new radiation-producing equipment, having documented safety protocols becomes critical.

Research shows that healthcare facilities implementing structured radiation safety programs with proper education can reduce median fluoroscopy time by 30-50%. The template provides clear documentation frameworks for all required program elements while allowing customization to match your specific operational needs.

Related categories

Preview of the template
Entity
Page 1
General Information
Facility Name
Radiation Safety Officer (RSO) Name
RSO Contact Information
Radiation Sources
List all radiation sources on-site
Provide details on isotope, activity, and use for each source
Radiation Protection Measures
Are appropriate shielding materials in place?
Are access controls (locks, alarms) in place?
Are radiation warning signs posted?
Is personnel monitoring (dosimetry) program in place?
Are radiation surveys conducted periodically?
Training and Procedures
Is radiation safety training provided to all authorized users?
Are there written procedures for safe handling of radioactive materials?
Are there emergency response procedures in place?
Waste Management
Is there a radioactive waste disposal program?
Are radioactive waste storage areas properly labeled and secured?
Are radioactive waste records maintained?
Audits and Reviews
Is the radiation safety program reviewed annually?
Are radiation safety program audits conducted periodically?
Are corrective actions taken for any program deficiencies?

Frequently asked questions

What are the essential components of a radiation safety program template?

A comprehensive radiation safety program template should include organizational structure, ALARA program details, dosimetry protocols, area monitoring procedures, radiological controls, emergency procedures, record-keeping systems, training requirements, and internal audit processes. These components ensure regulatory compliance while protecting personnel.

How do I implement the ALARA principle using this radiation safety program template?

The template guides you through establishing specific ALARA procedures focusing on time, distance, and shielding. You’ll document your commitment to keeping exposures below regulatory limits, create protocols for minimizing exposure time, establish proper distancing requirements, and specify appropriate shielding materials for different radiation sources.

How often should I update my radiation safety program documentation?

Your radiation safety program documentation should be reviewed annually at minimum, with updates whenever there are changes to equipment, procedures, regulations, or personnel. The template includes sections for documenting review dates, changes made, and verification signatures to maintain a complete audit trail.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.