Standards › Standard 27 › Forms
Form · TEL-FRM-002 · Version 1.0 · Approved by the ASF Expert Committee
Supports: 27.7
Purpose
Records each quarterly wellbeing and isolation check with a remote clinician, the support offered and any action.
How to complete
- Hold the check each quarter and record the date.
- Record the team contact and support route agreed.
- Record any warning sign and the action taken.
Checks
| Check | Entry |
|---|---|
| Clinician and check date | Yes |
| Team contact in the last quarter (yes or no) | Yes |
| Support route agreed | Yes |
| Warning sign (yes or no) and action | Yes |
| Checked by | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | Based on the WHO Recommendations on digital interventions for health system strengthening (2019) and the WHO Ethics and governance of artificial intelligence for health (2021). |
| 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
- Accréditation Sans Frontières (2026). ASF Policy Framework v1.2. (E-006)
- Accréditation Sans Frontières (2026). ASF Expert Committee consensus on Standard 1. (E-009)