Standards › Standard 31 › Forms
Form · DEN-FRM-009 · Version 1.0 · Approved by the ASF Expert Committee
Supports: 31.24
Purpose
Records each referral to another specialist, its reason, urgency, receipt and the reply.
How to complete
- Write the reason and urgency in the referral letter.
- Record the date sent and the receipt.
- Record the reply and the action taken.
Checks
| Check | Entry |
|---|---|
| Patient, date sent and urgency | Yes |
| Reason for referral | Yes |
| Receipt confirmed (date) | Yes |
| Reply and action taken | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | Based on the CDC guidelines for infection control in dental health-care settings (Kohn et al., 2003), ISO 17665 for moist-heat sterilisation, the Minamata Convention on Mercury (2013), IAEA Specific Safety Guide SSG-46 (2018), Council Directive 2013/59/Euratom, and the ADA guidelines on sedation (2016). |
| 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)