Office Of Environmental Health & Safety

Northeastern University
360 Huntington Avenue
346 Richards Hall
Boston, MA 02115-5000

phone: 617.373.2769
fax: 617.373.7622

ehs@neu.edu Image 2

Radioactive Material Order Form

Please fill in the following information to order your radioactive material:

Person Making Request:

Principal Investigator:

Building/Room Number:

Phone Number:

E-Mail Address:

Isotope: Other Isotope:

Vendor: Other Vendor:

PO Number:

Catalog Number:

Quantity Desired:

Quantity on Hand:

Date Requested:

Date you need order or other comments:

Please note:

  • All on-line orders will be confirmed by e-mail once placed.

  • This form is not secure so Procard use is not available at this time.

  • This form is only available from a Northeastern University computer.