Request for RAM Order Confirmation Number

This form must be completed by researchers prior to placing an order with vendor for radioisotopes. Once this form is submitted, radiation safety staff will review and provide a confirmation #. This # must be referred in your order with waynebuy or with vendors with existing PO.

Fields with asterisks (*) are required.

Request for RAM order confirmation number

First name *

Last name *

Email *

Lab Phone Number *

Approval holder /PI last name *

Radioisotope to be ordered *

Activity to be ordered ( microcuries) *

Chemical form *

Vendor name *

Remaining activity of radioactive material from previous order (uCi) *

Purchase order (PO) number ( if existing order)

Comments if any:

Will this be for animal injection? *

How many microcurries are you transferring to another builidng? *

Note: The shipping address for RAM order: Office of Environmental Health and Safety, 5425 Woodward, Suite 300, Detroit, MI 48202

Expected date for Arrival. Tracking delivery number should be provided to Rad Safety *

Rad staff to deliver to lab Room and Builidng *

Inventory update and Use Log completion