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International Accreditation of Healthcare Facilities

Standards › Standard 16 › Forms

Form · PED-FRM-002 · Version 1.0 · Approved by the ASF Expert Committee

Supports: 16.2

Purpose

Records the consent given by the legal guardian, and the child’s involvement and views, as their age allows.

How to complete

Checks

Check Entry
Legal guardian (name and relation) Yes
Child’s age and involvement (as age allows) Yes
Child’s views recorded Yes
Consent given by guardian (yes or no) Yes
Date and clinician Yes

Evidence

Reference Note
E-009 Based on the WHO Pocket book of hospital care for children (2013) and the UN Convention on the Rights of the Child (1989).
E-006 ASF Policy Framework v1.2. Adapted.
E-009 ASF Expert Committee consensus.

Change history

Version Date What changed Approval
1.0 the date of approval First version set Expert Committee approval

E-learning for this document

References

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