Standards › Standard S6 › Forms
Form · PTR-FRM-002 · Version 1.0 · Approved by the ASF Expert Committee
Supports: System S6 (Patient transfers and referrals), criterion S6.1, S6.2, S6.4, S6.6
Purpose
The written plan for one transfer, with the responsible party, handover points, timings, crew, escort, equipment and contingency.
How to complete
- Complete before the transfer is accepted.
- Fill each segment in order.
- Attach the care-level classification (PTR-SOP-002).
Checks
| Check | Entry |
|---|---|
| Responsible party named for each segment | Yes |
| Handover point for each change of segment | Yes |
| Route or flight and timings | Yes |
| Crew, escort and equipment named | Yes |
| Failure plan and alternative escort | Yes |
| Care level recorded | Yes |
| Plan approved by and date | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | ASF Expert Committee consensus. |
| 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
No e-learning course is linked to this document yet.
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)