Laser Registration Form
All Class 3b and 4 lasers, including embedded Class 3b and 4 lasers, must be registered with Environmental Health and Safety Department. To register your laser, complete this form and email it to radiationsafety@utm.edu
Contact Information | |
Principal Investigator’s Name: | |
Principal Investigator’s Email: | |
Contact Name: | |
Contact Email: | |
All individuals operating this laser: | |
Check here if laser is in storage | |
Building: | |
Room: | |
Department: |
Laser Information
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Laser Identification Information | ||||
Laser Manufacturer: | ||||
Model Number: | ||||
Serial Number: | ||||
Laser Type (Nd, YAG, etc.): | ||||
Classification (3b or 4): | ||||
Optical Characteristics | ||||
Wavelength (nm): | ||||
Beam Diameter (mm): | ||||
Beam Divergence (mrad): | ||||
Mode | ||||
Continuous Wave |
Average Power (watts): Repetition frequency: | |||
Pulsed |
Joules/pulse: | |||
Q-Switched |
Pulse Width: |
Purpose or Use:
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