AF Form 2753: Radiological Sampling Form Guide & Download

AF Form 2753: Radiological Sampling Form Guide & Download – The AF Form 2753, officially titled Radiological Sampling Form, is a critical document used by the United States Air Force to document and submit radiological samples for analysis. It ensures accurate assessment of potential radiation exposure and supports entry of data into the Air Force Master Radiation Exposure Registry (MRER), as required by federal regulations including 10 CFR 20.

Bioenvironmental Engineers (BEs), Radiation Safety Officers (RSOs), and personnel handling radioactive materials (RAM) or working in environments with potential ionizing radiation exposure rely on this form. Proper use helps maintain compliance with Air Force radiation protection standards while protecting the health of Airmen, Guardians, and civilians.

What Is AF Form 2753 and Why Is It Important?

AF Form 2753 captures essential details about environmental, liquid, swipe, air, water, soil, vegetation, or bioassay samples (such as urine, fecal, or blood). The primary purpose is to characterize potential exposure to radioactive material so that internal and external doses can be accurately assessed and recorded.

Key regulatory foundations include:

  • 10 U.S.C. 8013
  • Executive Order 12196
  • 10 CFR 20.2106 (Records of Individual Monitoring Results)
  • 29 CFR 1910.1096 (Occupational Exposure to Radiation)

The form supports the ALARA principle (As Low As Reasonably Achievable) and ensures doses are properly documented in the MRER. Failure to provide complete information can prevent accurate dose assessment and regulatory compliance.

Note: Completing AF Form 2753 does not replace timely entry into the Defense Occupational and Environmental Health Readiness System (DOEHRS). Always update DOEHRS as soon as possible for comprehensive documentation.

Who Uses AF Form 2753?

  • Installation Radiation Safety Officers (RSOs) and Unit Radiation Safety Officers (URSOs)
  • Bioenvironmental Engineers (4B0X1)
  • Personnel submitting bioassay samples (routine, baseline, post-mission/TDY)
  • Teams handling environmental sampling near RAM or radiation-producing devices (RPDs)
  • Laboratories such as the U.S. Air Force School of Aerospace Medicine (USAFSAM) Analytical Services Division at Wright-Patterson AFB, OH

It is prescribed by AFMAN 48-148, Ionizing Radiation Protection (20 July 2020), which remains the primary governing manual for ionizing radiation safety in the Air Force.

When to Use AF Form 2753?

Use the form whenever submitting samples for radioanalysis, including:

  • Bioassay samples (urine, fecal, blood) to assess internal contamination from inhalation, ingestion, injection, or absorption
  • Environmental samples (air, water, soil, vegetation, swipes/swabs)
  • Pre- and post-TDY or mission monitoring
  • Routine occupational monitoring
  • Incident or suspected exposure investigations
  • Radon or other natural source assessments (in coordination with applicable guidance)

The reason for the bioassay or sampling is required—samples will not be analyzed without it.

How to Fill Out AF Form 2753: Key Sections and Instructions?

Download the current official form here: AF Form 2753 PDF

The form includes Privacy Act protections. Information helps assess dose and may be shared with the Nuclear Regulatory Commission (NRC) for regulatory purposes. Disclosure is voluntary, but incomplete data hinders proper dose posting.

1. Administrative Data / Mailing and Recipient Information

  • Mail Samples To: USAFSAM/OEAL, 2510 5th St, Bldg 840, Area B, Wright-Patterson AFB, OH 45433
  • Workplace or Site Identifier: Base, Organization, Workplace/Site, Building, Room/Area
  • Send Results To: Specify base code, name/grade/AFSC, and email for original/copy results
  • Collection Dates and Times: Date and time (24-hour clock) collection began and ended. For 24-hour urine samples, follow specific guidance (begin after first void; end with first void the next day). For spot samples, use the same begin/end time.
  • Sample Collected By: Name, signature, and DSN of the collector

2. Sample Identification and Type

  • Base Sample Numbers: Use the required prefix format (e.g., first character for collection method like T for 24-hour void, second for type like U for urine).
  • Analysis Requested: Gamma Spectroscopy, Alpha Spectroscopy, Gross Alpha/Beta Counting, Scintillation Analysis (select all that apply).
  • Sample Type: Environmental, Liquid, Swipe/Swab, Air/Water, Soil/Vegetation, Urine/Fecal/Blood/Other. Include surface area or volume in the narrative.

3. Subject Information (for Bioassay)

  • Name, SSN (required for dose assessment), height (inches), weight (pounds), sex, pregnant (Yes/No/NA)
  • Route of Exposure: Inhalation, Ingestion, Injection, Absorption (select all applicable)
  • Dates and times of exposure

4. Radionuclide Information

  • Isotope(s) suspected or known
  • Chemical Form/Physical Description/Comments (include Inhalation Class if from inhalation exposure)
  • Exposure Narrative: Detailed description of work, location, protective equipment used, conditions, and any other relevant details. For TDY/mission-related sampling, describe the work performed.
  • Reason for Bioassay (mandatory field)

5. Certification and Signature

Certify that the sample does not contain hazardous wastes as defined by 40 CFR 261 (or disclose if it does). Sign and date.

Pro Tip: Provide as much detail as possible in the Exposure Narrative and Reason for Bioassay sections. Incomplete forms delay analysis.

Submission Process

  1. Complete AF Form 2753 accurately.
  2. Package the sample properly following USAFSAM laboratory sampling guide requirements (chain of custody, labeling, shipping regulations for potential radioactive material).
  3. Forward the original form with the sample to USAFSAM.
  4. Retain a copy locally until results are received and entered into DOEHRS/MRER.
  5. Ensure results are reviewed by the local RSO or BE for dose assessment and ALARA program adjustments.

Turnaround times vary by analysis type; contact USAFSAM Customer Service for priority requests (acute health risk or mission impact only).

  • AFMAN 48-148: Ionizing Radiation Protection (primary reference)
  • AFMAN 40-201: Radioactive Materials (RAM) Management
  • DAFMAN 48-125: Personnel Ionizing Radiation Dosimetry
  • USAFSAM Laboratory Sampling Guide (for detailed collection, handling, and analysis instructions)

Always check the official e-Publishing website (www.e-publishing.af.mil) for the most current versions of these publications, as guidance can be updated.

Best Practices for Radiation Safety Compliance

  • Integrate sampling into your unit’s radiation protection program.
  • Train personnel on proper sample collection techniques.
  • Document everything in DOEHRS promptly.
  • Maintain the ALARA mindset: minimize time, maximize distance, and use shielding.
  • For radon assessments in housing, workplaces, or child development centers, follow specific AFMAN 48-148 Chapter 7 guidance.

Download AF Form 2753

Official Link: https://static.e-publishing.af.mil/production/1/af_sg/form/af2753/af2753.pdf

For questions about your installation’s program, contact your local Bioenvironmental Engineering Flight or Radiation Safety Officer.

This guide is for informational purposes and is based on publicly available Air Force publications as of 2026. Always consult your chain of command, local RSO, or the most recent official directives for mission-specific guidance.

By following proper procedures with AF Form 2753, Air Force personnel help ensure radiation exposures remain well-controlled, supporting both individual health and operational readiness.