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> NRC Form 396 - Certification of Medical Examination by Facility Licensee
| Form Number: |
NRC
Form 396  |
| Form Title: |
Certification of Medical Examination by Facility Licensee |
| Current Edition: |
4-2009 |
| Authority Directive or Regulation: |
10
CFR 55.21, 55.23,
55.25,
55.27,
55.31,
55.33
and 55.57 |
| Form Status: |
Approved by OMB: 3150-0024, Expires: 4/30/2012 |
| Special Instructions: |
Instructions are on Page 2 of the form.
NRC Form 396, ACertification of Medical Examination by Facility Licensee,@ must accompany the NRC Form 398 unless a waiver of the medical examination is being requested. |
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