h. DA Form 4465 (ADAPCP Military Client Intake and Follow -Up Record).
This form is prepared , kept, and used in accordance with AR 600 - 85 and filed in the
HREC.
i. DD Form 1141 (Record of Occupational Exposure to Ionizing Radiation).
This form and any earlier records of personnel dosimetry must be kept in the HREC.
Dosimetry is defined as "the determination by scientific methods of the amount , rate,
and distribution of radiation emitted from a source of ionizing radiation." When a person
changes stations or leaves the service, these records are moved with the HREC. The
dosimetry records of personnel whose work exposes them to ionizing radiation may be
removed from their HREC and filed separately. This is done when the medical officer
who keeps and uses the records does not have easy access to the HREC of these
personnel. In these cases, the separate file of dosimetry records is kept as described
in AR 40-14. See figure 2-16.
(1) When dosimetry records are temporarily withdrawn from the HREC, an
OF 23 (Chargeout Record) is filed in their place. Under the column "Identification of
Record" on OF 23, enter the numbers of the forms removed. In the column "Charged
To," enter the name of the medical officer (or other authority) borrowing the records and
the name and address of the MTF (or activity) where these records are kept. Enter the
date the record is removed in the "Date Charged Out" column.
(2) The OF 23 will not be removed from the HREC until the dosimetry
records are returned.
MD0751
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