Code of Federal Regulations Title 10. Energy § 10.55.23 Certification

To certify the medical fitness of the applicant, an authorized representative of the facility licensee shall complete and sign NRC Form 396, “Certification of Medical Examination by Facility Licensee,” which can be obtained by writing the Office of the Chief Information Officer, U.S. Nuclear Regulatory Commission, Washington, DC 20555–0001, by calling (301) 415–7232, or by visiting the NRC's Web site at http://www.nrc.gov and selecting forms from the index found on the home page.