Imaging Justification and Dose Log
Every examination justified by a clinical question, optimised to the lowest dose that answers it, and recorded — the three principles on one sheet
What it is
A justification checklist for the referrer and radiographer (clinical question, previous imaging, alternatives without radiation, pregnancy check) and a dose log per examination (protocol, kV/mAs or DLP, repeat exposures and why), with the monthly review against diagnostic reference levels.
Where to use it
Every imaging department; the log reviewed monthly by the radiologist and the radiation protection officer. Evidence for: Hospital Standard 4 — radiation safety (justification, optimisation, records). Evidence for: Hospital Standard 4 — radiation safety (justification, optimisation, records). Evidence for: Hospital Standard 4 — radiation safety (justification, optimisation, records).
Translate and adapt
English master edition. Georgian and other translations are added as they are clinically reviewed. Any facility may translate, add its logo and adapt wording to local practice — keeping the ASF block, the source attribution and the licence line on the sheet. Clinical thresholds and drug doses must be confirmed against national protocols before use.
The same code is printed on the tool itself. Scan it in any facility to reach this page.
Could You Be Pregnant? — Check Before X-ray, CT and Nuclear Medicine
Contrast Media Reaction — Prevent, Recognise, Treat
Print to share.
