RTH-FRM-002: Daily treatment verification record

Standards › Standard 57 › Forms

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

Supports: 57.2

Purpose

Records the identity and set-up check made before each fraction.

How to complete

• Record the patient identity check.
• Record the set-up check against the plan.
• Record any pause and the review made.

Checks

Check	Entry
Patient identity verified (yes or no)	Yes
Set-up checked against plan (yes or no)	Yes
Pause and review (if set-up differed)	Yes
Radiographer and date	Yes

Evidence

Reference	Note
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

• Oncology & Infusion Therapy Safety Endorsement (AMB-11)

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)