Date Insert additional boxes as needed. PROTOCOL REVIEW AND WALKTHROUGH Authorized User Print Name Ken Czerwinski Date 13-Dec-16 Sign 13-Dec-17 Exp. Date PROTOCOL APPROVAL Radiation Safety Officer (if required) Print Name Date Sign Exp. Date
Date Insert additional boxes as needed. PROTOCOL REVIEW AND WALKTHROUGH Authorized User Print Name Ken Czerwinski Date 13-Dec-16 Sign Exp. Date 13-Dec-17 PROTOCOL APPROVAL Radiation Safety Officer (if required) Print Name Date Sign Exp. Date