AUTHORIZED NUCLEAR PHARMACIST TRAINING, 

EXPERIENCE, AND PRECEPTOR ATTESTATION 

[10 CFR 35.55]

NRC FORM 313A (ANP)

(07-31-2023)

U. S. NUCLEAR REGULATORY COMMISSION

NRC FORM 313A (ANP) (07-31-2023) PAGE 1 

APPROVED BY OMB: NO. 3150-0120 EXPIRES: 07/31/2026

Name of Proposed Authorized Nuclear Pharmacist State or Territory Where Licensed

PART I -- TRAINING AND EXPERIENCE 

(Select one of the two methods below)

 1. Board Certification

a. Provide a copy of the board certification and stop here.

Training and Experience, including board certification, must have been obtained within the 7 years preceding the date 

of application or the individual must have obtained related continuing education and experience since the required 

training and experience was completed. Provide dates, duration, and description of continuing education and 

experience related to the nuclear pharmacy uses.

*

 2. Structured Educational Program for Proposed Authorized Nuclear Pharmacist

Description of Training

Radiation physics and 

instrumentation

Location of Training Clock 

Hours

Dates of 

Training*

Radiation protection

Mathematics pertaining to the use 

and measurement of radioactivity

Chemistry of byproduct material for 

medical use

Radiation biology

Total Hours of Training:

a. Classroom and Laboratory Training.

Estimated burden per response to comply with this mandatory collection request: 4.3 hours. Submittal of the application is 

necessary to determine that the applicant is qualified and that adequate procedures exist to protect the public health and 

safety. Send comments regarding burden estimate to the FOIA, Library, and Information Collections Branch (T-6 A10M), 

U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001, or by email to Infocollects.Resource@nrc.gov, and the 

OMB Reviewer at: OMB Office of Information and Regulatory Affairs, (3150-0120), Attn: Desk Officer for the Nuclear 

Regulatory Commission, 725 17th Street NW, Washington, DC 20503; email: oira_submission@omb.eop.gov. The NRC 

may not conduct or sponsor, and a person is not required to respond to, a collection of information unless the document 

requesting or requiring the collection displays a currently valid OMB control number.
NRC FORM 313A (ANP) U. S. NUCLEAR REGULATORY COMMISSION

(07-31-2023)

AUTHORIZED NUCLEAR PHARMACIST TRAINING, EXPERIENCE, 

AND PRECEPTOR ATTESTATION [10 CFR 35.55] (continued)

Description of Experience

Shipping, receiving, and performing 

related radiation surveys

Location of Experience/License or 

Permit Number of Facility

Clock 

Hours

Dates of 

Experience*

Using and performing checks for 

proper operation of instruments used 

to determine the activity of dosages, 

survey meters, and, if appropriate, 

instruments used to measure alphaor beta-emitting radionuclides

Calculating, assaying, and safely 

preparing dosages for patients or 

human research subjects

PAGE 2 

Using administrative controls to avoid 

medical events in administration of 

byproduct material

Using procedures to prevent or 

minimize radioactive contamination 

and using proper decontamination 

procedures

Total Hours of Experience:

Supervising Individual

c. Go to and complete Part II Preceptor Attestation.

b.

 2. Structured Educational Program for Proposed Authorized Nuclear Pharmacist (continued)

Supervised Practical Experience in a Nuclear Pharmacy.

NRC FORM 313A (ANP) (07-31-2023)
U. S. NUCLEAR REGULATORY COMMISSION

AUTHORIZED NUCLEAR PHARMACIST TRAINING, EXPERIENCE, 

AND PRECEPTOR ATTESTATION [10 CFR 35.55] (continued)

NRC FORM 313A (ANP)

(07-31-2023)

PART II – PRECEPTOR ATTESTATION

PAGE 3

Note: This part must be completed by the individual's preceptor. The preceptor does not have to be the supervising 

individual as long as the preceptor provides, directs, or verifies training and experience required. If more than 

one preceptor is necessary to document experience, obtain a separate preceptor statement from each.

First Section

Complete the following:

Structured Educational Program

I attest that 

Name of Proposed Authorized Nuclear Pharmacist

has satisfactorily completed a 700-hour structured

educational program consisting of both practical experience in nuclear pharmacy and 200 hours of 

classroom and laboratory training, as required by 10 CFR 35.55(b)(1) and is able to independently fulfill the 

radiation safety-related duties as an authorized nuclear pharmacist.

Nuclear Pharmacy or Medical Facility

License/Permit Number

Name of Preceptor Signature Date

I am an Authorized Nuclear Pharmacist for ,

.

Telephone Number

Second Section

Complete the following for preceptor attestation and signature:

NRC FORM 313A (ANP) (07-31-2023)