Dose history request form

What am I requesting?

The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) may hold an individual’s occupational dose records in different databases. ARPANSA may hold some or all of your dose records if they were submitted to the Australian National Dose Register (ANRDR) by your employer or if you were ever monitored for occupational exposure by our Personal Radiation Monitoring Service (PRMS). You can request a report detailing your history of radiation doses (if held by ARPANSA) by completing this online form. You will be notified of the outcome by email.

This service is provided free of charge by ARPANSA.

Personal information held by ARPANSA

To help us identify you, ARPANSA has been provided with some or all of the following information:

  • full name
  • date of birth
  • gender
  • employee number.

Your personal information is handled in accordance with the Privacy Act 1988 and is not disclosed or used for any purpose other than to identify you.

Can I request a dose history report on behalf of someone else?

Generally, a person can only request his or her own dose history report. If you need to request a report on behalf of someone else, this can be done by providing a signed authorisation letter from the individual to whom the report pertains, or other legal instrument, such as power of attorney. Such situations will be assessed on a case-by-case basis. If you require further information, you can contact the ANRDR at anrdratarpansa.gov.au.

Misleading or false information

Please note that it is an offence to provide misleading or false information.

Further information

If you require further information, please contact the ANRDR at anrdratarpansa.gov.au.

Online form

Please complete the online form below to request your personal dose history report.

Files must be less than 2 MB.
Allowed file types: pdf doc docx.
Files must be less than 2 MB.
Allowed file types: pdf doc docx.
Files must be less than 2 MB.
Allowed file types: pdf doc docx.

Employment history (most recent first). You can list up to three employers.

Employer 1

Please provide an employment end date. If this employer is current, please enter 'current employer' below.

Employer 2

Please provide an employment end date. If this employer is current, please enter 'current employer' below.

Employer 3

Please provide an employment end date. If this employer is current, please enter 'current employer' below.

Declaration: