Table 1.

Survey questionnaire for IAEA Smart Card/SmartRadTrack Project, Form 1. Questions addressing prior radiation tracking programs, the potential usefulness of such a program, and familiarity with IAEA efforts in this area.

1. 1. Do you currently have a program to track medical radiation procedures and/or doses to your population? ☐No ☐No, but such a program is actively being planned (If you responded “No, but such a program is actively being planned”, please proceed to Smart Card/SmartRadTrack Form 2) ☐Yes, only for tracking procedures but not for dose ☐Yes (If you responded “Yes” to Question 1, please proceed to Smart Card/SmartRadTrack Form 3) ☐Don’t know

2. Are you aware of the IAEA’s Smart Card/SmartRadTrack program? ☐Yes ☐No

3. Are you interested in joining and promoting such a program in your country? ☐Yes ☐No

4. Did you previously have such a program? ☐Yes ☐No ☐Unsure

If yes, please describe your discontinued program (s) to track medical radiation exposures/doses, and why they were discontinued:

5. How useful do you think a radiation exposure tracking program would be (assuming practicalities are attended to)? ☐Extremely useful ☐Very useful ☐Moderately useful ☐Mildly useful ☐Not useful

6. Would you be interested in learning more about the IAEA’s Smart Card/SmartRadTrack program? ☐Yes ☐No

7. Do you need IAEA resources to establish such a program in your country? ☐Yes, if my country is eligible under IAEA norms ☐We need no funds but technical collaboration with the IAEA ☐No

8. Please identify others in your country that would be candidates for a pilot study to participate in a worldwide radiation tracking program (Name, email ID, organization)