Working in controlled areas outside GSI

When you work in controlled areas outside GSI you usually need a dose report with the information of the date of the last medical examination. Or the radiation proection group of the institute asks you to give a form to be filled out by the radiation protection group of GSI. The form below gives you the opportunity to let us know that you will have an experiment outside GSI and that you need a dose report and/or a form filled out by the dosimetry group of GSI.

If you have questions or any comments, please write an email to Frau Dr. Knapp.

Working outside GSI

Please fill out the following form. Mandatory fields are marked with a star *.

Please inform us, when and where you have an experiment outside GSI.

You will find the information on data protection under the following link: https://www.gsi.de/das/infopflichten.

Last name*

First name*

E-Mail

Name of the external insitute you will work*

Address of the institute

Beginning of business trip*

End of business trip*

Short description of the experiment*

Will other persons from GSI participate in the experiment? If yes, please write down the name of persons; please add the beginning and end of business trip behind each name.

Other persons

If you need a dose report or the special form signed by radiation protection for your work or the access to controlled areas in the external institute, you have here the opportunity to tell us what you need.

I need

Dose report with date of the last medical examination (in German)

Dose report with date of the last medical examination (in English)

Form/Template in the attachment filled out and signed by radiation protection

Upload of the form/template you need filled out and signed by the radiation protection.

Form/Template

Until which date you need the dose report or the special form?

Don't fill this field!