Therapy TLD Order Form

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University of Wisconsin
Medical Radiation Research Center
Radiation Calibration Laboratory (ADCL)

1111 Highland Avenue, WIMR Rm B1002
Madison, WI 53705-2275
Phone: (608) 262-6320

 

THERAPY TLD ORDER FORM

This service is used to independently verify the output of a clinical linear accelerator. Patient TLDs are placed on the patient at the site of interest. Dose-response TLDs are irradiated under reference conditions to a known dose using the same energy as the patient TLDs.

All TLDs in a set must be returned at the same time. TLDs from different sets will have different sensitivities and should not be used interchangeably.

Each order is shipped via FedEx Priority to arrive by 10:30AM. A $15 shipping fee is included with all orders.

Physicist Name(Required)
Shipping Address(Required)
Billing Contact(Required)
Billing Address(Required)

Therapy Patient Monitoring Service: Sets of 3 Patient TLDs ($100.00/set)

Please enter a number from 1 to 100.

Therapy Patient Monitoring Service: Sets of 5 Patient TLDs ($125.00/set)

Please enter a number from 1 to 100.

Therapy Patient Monitoring Service-Custom Sets: > 5 Patient TLDs ($25.00/Patient TLD)

If you would like a set of TLDs with more than 5 patient TLDs, please enter the total number of patient TLDs in each set, and number of sets you would like below.

Please enter a number from 6 to 100.
Please enter a number from 1 to 100.
Please enter a number from 6 to 100.
Please enter a number from 1 to 100.
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If you have any questions or if you do not see the Therapy TLD Service you are looking for, please contact us directly at rmm@uwmrrc.wisc.edu or 608/265-9579.
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UWMRRC