Standards › Standard 25 › Forms
Form · HMG-FRM-002 · Version 1.0 · Approved by the ASF Expert Committee
Supports: 25.2
Purpose
Records the teach-back check of the patient’s understanding of their care and the health system.
How to complete
- Ask the patient to explain the care in their own words.
- Record what was understood and what was not.
- Re-explain what was not understood and check again.
Checks
| Check | Entry |
|---|---|
| Care explained (plain language, language used) | Yes |
| Teach-back: understood (yes or no) | Yes |
| Health system steps explained | Yes |
| Re-explained where needed | Yes |
| Clinician and date | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | Based on the WHO and IOM Global Competency Standards for Refugee and Migrant Health and the WHO mhGAP Intervention Guide (2019). |
| 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)