A red asterisk indicates a required field.  To learn more about radiation dosimeters, visit our Personnel Monitoring page.  

Employees who have been issued dosimeters may contact EHRS (215-898-7187) to review their individual record of doses received.

Have you been previously monitored while employed elsewhere?
If yes, please list your previous work record below:
Please choose one of the following three options:
Submission of this Dosimeter Request Form provides acknowledgement on my behalf that EHRS may adjust my dose results, at any time, to account for situations such as incorrect dosimeter wear, lost dosimeter and use of protective lead aprons and/or eyewear.