Rutgers Environmental Health and Safety
Instructions for Completing:
Isotope Order Form
Enter your name.
Enter your email address.
Enter the 4-digit number assigned to the authoree ordering the isotope.
Enter the name of the authoree ordering the isotope.
Enter the Purchase Order Number assigned to your isotope order.
Enter the date your order was placed with the vendor.
Enter the name of the vendor or company with whom you placed your order.
Enter the name of the building where the isotope is to be delivered.
Enter the room number where the isotope is to be delivered.
Choose one of two choices from the pull-down menu:
Select the isotope from the pull-down menu. If your selection is not listed, choose
*Other and enter the isotope name in the space provided.
For more information, contact
Last Updated: 02/03/2013
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