35.500 Sealed sources for diagnosis (specify device)

NRC FORM 313A (AUD)

(07-31-2023)

AUTHORIZED USER TRAINING, EXPERIENCE AND 

PRECEPTOR ATTESTATION 

(for uses defined under 35.100, 35.200, and 35.500) 

[10 CFR 35.57, 35.190, 35.290, and 35.590]

U. S. NUCLEAR REGULATORY COMMISSION

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

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

Name of Proposed Authorized User State or Territory Where Licensed

Requested Authorization(s) (check all that apply)

35.100 Uptake, dilution, and excretion studies 35.200 Imaging and localization studies

PART I -- TRAINING AND EXPERIENCE 

(Select one of the three methods below)

 1. Board Certification

a. Provide a copy of the board certification.

b. For a board certification issued on or before October 24, 2005 that is listed in 10 CFR 35.57(b)(2)(i), provide 

 the following:

 2. Current 35.390 Authorized User Seeking Additional 35.290 Authorization

a. Authorized user on Materials License meeting 10 CFR 35.390, 10 CFR 35.57 for 35.300 

uses, or equivalent Agreement State requirements seeking authorization for 35.290.

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 uses checked above.

*

(i) Documentation that the individual performed each use checked above on or before October 24, 2005.

(ii) Dates, duration, and description of continuing education and experience within the past seven years for 

 each use checked above.

c. Stop here.

Supervisor meets the requirements below, or equivalent Agreement State requirements (check all that apply).

Description of Experience

Eluting generator systems 

appropriate for the preparation of 

radioactive drugs for imaging and 

localization studies, measuring and 

testing the eluate for radionuclidic 

purity, and processing the eluate 

with reagent kits to prepare labeled 

radioactive drugs

Location of Experience/License or 

Permit Number of Facility

Clock 

Hours

Dates of 

Experience*

Total Hours of Experience:

35.290 35.390 + generator experience in 32.290(c)(1)(ii)(G)

b. Supervised Work Experience.

(If more than one supervising individual is necessary to document supervised work experience, provide multiple 

copies of this section.)

Supervising Individual License/Permit Number listing supervising individual as an 

authorized user or authorized nuclear pharmacist

35.55 35.57 for 35.200 uses

c. If board certified, provide a copy of the certificate and stop here. If not board certified, skip to and complete 

 Part II Preceptor Attestation. 

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 (AUD)

(07-31-2023)

AUTHORIZED USER TRAINING, EXPERIENCE AND PRECEPTOR ATTESTATION 

(for uses defined under 35.100, 35.200, and 35.500) 

[10 CFR 35.57, 35.190, 35.290, and 35.590](continued)

U. S. NUCLEAR REGULATORY COMMISSION

3. Training and Experience for Proposed Authorized User

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 (not required for 

35.590)

Radiation biology

Total Hours of Training:

Description of Experience 

Must Include:

Ordering, receiving, and unpacking 

radioactive materials safely and 

performing the related radiation 

surveys

Location of Experience/License or 

Permit Number of Facility Confirm Dates of Experience*

Performing quality control 

procedures on instruments used to 

determine the activity of dosages 

and performing checks for proper 

operation of survey meters

PAGE 2 

a. Classroom and Laboratory Training.

Supervised Work Experience (completion of this table is not required for 35.590). 

(If more than one supervising individual is necessary to document supervised work experience, 

provide multiple copies of this section.)

b.

Total Hours of 

Experience: Supervised Work Experience

No

Yes

No

Yes

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

(07-31-2023)

AUTHORIZED USER TRAINING, EXPERIENCE AND PRECEPTOR ATTESTATION 

(for uses defined under 35.100, 35.200, and 35.500) 

[10 CFR 35.57, 35.190, 35.290, and 35.590](continued)

U. S. NUCLEAR REGULATORY COMMISSION

Supervising Individual License/Permit Number listing supervising individual as an 

authorized user or an authorized nuclear pharmacist for generator 

training

Supervisor meets the requirements below, or equivalent Agreement State requirements (check one).

35.190 35.290 35.390 35.390 + generator experience in 35.290(c)(1)(ii)(G)

Device Type of Training Location and Dates

Description of Experience 

Must Include:

Location of Experience/License or 

Permit Number of Facility Confirm Dates of 

Experience*

Using administrative controls to 

prevent a medical event involving the 

use of unsealed byproduct material

Using procedures to contain spilled 

byproduct material safely and using 

proper decontamination procedures

Administering dosages of radioactive 

drugs to patients or human research 

subjects

Eluting generator systems appropriate 

for the preparation of radioactive 

drugs for imaging and localization 

studies, measuring and testing the 

eluate for radionuclidic purity, and 

processing the eluate with reagent 

kits to prepare labeled radioactive 

drugs

3. Training and Experience for Proposed Authorized User (continued)

b. Supervised Work Experience. (continued)

For 35.500 uses only, stop here. For 35.100 and 35.200 uses, skip to and complete Part II Preceptor Attestation.

c. For 35.590 only, provide documentation of training on use of the device.

d.

No

Yes

No

Yes

No

Yes

No*

Yes

Calculating, measuring, and safely 

preparing patient or human research 

subject dosages No

Yes

PAGE 3 

35.55 35.57 for 35.200 uses

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

*Not required for 10 CFR 35.100 use.
NRC FORM 313A (AUD)

(07-31-2023) AUTHORIZED USER TRAINING, EXPERIENCE AND PRECEPTOR ATTESTATION 

(for uses defined under 35.100, 35.200, and 35.500) 

[10 CFR 35.57, 35.190, 35.290, and 35.590](continued)

U. S. NUCLEAR REGULATORY COMMISSION

PART II – PRECEPTOR ATTESTATION

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. (Not 

required to meet training requirements in 35.590)

First Section

Check one of the following for each use requested:

By checking the boxes below, the preceptor is not attesting to the individual's "general clinical competency."

For 35.190

I attest that 

Name of Proposed Authorized User

has satisfactorily completed the 60 hours of training and

experience, including a minimum of 8 hours of classroom and laboratory training, required by 10 CFR 35.190(c)(1), 

and is able to independently fulfill the radiation safety-related duties as an authorized user for the medical uses 

authorized under 10 CFR 35.100.

For 35.290

I attest that 

Name of Proposed Authorized User

has satisfactorily completed the 700 hours of training

and experience, including a minimum of 80 hours of classroom and laboratory training, required by 10 CFR 

35.290(c)(1), and is able to independently fulfill the radiation safety-related duties as an authorized user for the 

medical uses under 10 CFR 35.100 and 35.200.

Second Section

Complete one of the following for attestation and signature:

I meet the requirements below, or equivalent Agreement State requirements, as an authorized user for:

35.190 35.290 35.390 35.390 + generator experience 35.57 for 35.200 uses

OR

Residency Program Director:

I affirm that the attestation represents the consensus of the residency program faculty where at least one 

faculty member is an authorized user who meets the requirements below or equivalent Agreement State 

requirements for:

35.190 35.290 35.390 35.390 + generator experience 35.57 for 35.200 uses

I affirm that this facility member concurs with the attestation I am providing as program director.

I affirm that the residency training program is approved by the:

Residency Review Committee of the Accreditation Council for Graduate Medical Education

Royal College of Physicians and Surgeons of Canada

Council on Post-Graduate Training of the American Osteopathic Association

I affirm that the residency training program includes training and experience specified in:

35.190 35.290

Name of Preceptor or Residency Program Director (Typed or Printed)

Signature

Telephone Number Date

Name of Facility: License/Permit Number:

NRC FORM 313A (AUD) (07-31-2023) PAGE 4 

Authorized User: