Standards › Standard 19 › Forms
Form · SPC-FRM-003 · Version 1.0 · Approved by the ASF Expert Committee
Supports: 19.8
Purpose
Records that the patient was told what will be taken and why, and whether they agreed or declined.
How to complete
- Tell the patient what will be taken and why.
- Record the agreement, or the refusal and what was explained.
- Record what happens when a patient declines.
Checks
| Check | Entry |
|---|---|
| Patient told what will be taken and why (yes or no) | Yes |
| Agreed or declined | Yes |
| Explanation of what happens if declined | Yes |
| Refusal recorded with reason (if declined) | Yes |
| Collector and date | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | Based on ISO 15189:2022 (pre-examination processes) and the WHO Patient Safety Curriculum Guide (2011). |
| 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)