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Maryland Department of the Environment

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Preceptor Attestation Forms

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Following are links to required Preceptor Attestation Forms.

  • Authorized Medical Physicist Training and Experience and Preceptor Attestation (10 CFR 35.51)​
  • Authorized Nuclear Pharmacist Training and Experience and Preceptor Attestation (10 CFR 35.55) ​​
  •  Authorized User Training and Experience and Preceptor Attestation (for uses defined under 10 CFR 35.100, 35.200, and 35.500) ​​
  • Authorized User Training and Experience and Preceptor Attestation (for uses defined under 10 CFR 35.300)​​
  • Authorized User Training and Experience Preceptor Attestation(for uses defined under 35.400 and 35.600)​
  • Radiation Safety Officer (RSO or ARSO) training, experience, and preceptor attestation (10 CFR 35.57, 35.50)​​​​

Contact Information

For further information contact Norman Brown at 410-537-3300, or email norman.brown1@maryland.gov​

Additional Links

  • Radioactive Materials Licensing Forms
  • Radiological Health Program Home


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Maryland Department of the Environment
1800 Washington Blvd
Baltimore, MD 21230
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