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NRC Form 396: Operator Medical Exam Certification

Reactor operators need a medical certification before an NRC operator license is issued or renewed, and NRC Form 396 is how the facility tells the NRC that the examining physician found the applicant or operator medically qualified. It also requests any license conditions the physician recommends, such as corrective lenses, prescribed medication, a therapeutic device or more frequent medical status reports.

Who completes it

The facility licensee prepares it, and the examining physician (MD or DO) supplies Section A: name, state license number, certification date, the ANSI/ANS guidance used and any recommended conditions with a supporting narrative. The applicant or operator signs Section B and a senior management representative certifies Section C.

Submitting and payment

How to submit it
The facility submits it to the NRC electronically (for example through EIE) or by mail, with NRC Form 398 for initial and renewal applications (renewals at least 30 days before expiration) or within 30 days of learning of a new permanent condition.

Good to know

  • For conditions in boxes 4 to 11, the physician provides a brief narrative: pertinent history, objective findings such as blood pressure, HbA1c or TSH, diagnosis, and treatment including drug name and dosing.
  • The physician certifies against a checked version of ANSI/ANS-3.4 or ANSI/ANS-15.4, or an approved NRC alternative, and the documentation must be available for NRC review.
  • If more than 24 months pass between an applicant's initial exam and the licensing action, the applicant must be reexamined and a new Form 396 submitted.
  • Only permanent conditions are reported; temporary conditions for operators on administrative hold are not. The form is marked PII and withheld under 10 CFR 2.390.

Get the official form

Download the current version from the source each time; forms change without notice.

Certification of Medical Examination by Facility Licensee

Official pagePDF

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

What does the physician provide on NRC Form 396?

In Section A, the physician's printed name with MD or DO, state license number, and certification date, plus the ANSI/ANS guidance followed. The physician also recommends license conditions, such as corrective lenses, a hearing aid, medication, a CPAP or other therapeutic device, or medical status reports every 3, 6 or 12 months, with supporting medical evidence.

When must a facility submit NRC Form 396?

With NRC Form 398 for an initial license application, and with Form 398 at least 30 days before an operator license expires for renewal. During the license term, the facility must submit it within 30 days of learning that an operator has a permanent condition that can be mitigated by a license restriction.

Can the physician recommend a waiver of an ANSI medical requirement?

Yes. If an applicant or operator fails a requirement but demonstrates complete capacity to perform assigned duties on a test the physician administers, the physician may recommend and justify a waiver of that portion of the ANSI standard. For applicants, the waiver request is made on NRC Form 398, box 12.c.3.