Sync template from atomicqms-style deployment

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# Document Change Request Form
| Form ID | FRM-001 | Revision | 1.0 |
|---------|---------|----------|-----|
---
## Section 1: Request Information
| Field | Entry |
|-------|-------|
| Request Date | |
| Requested By | |
| Department | |
## Section 2: Document Information
| Field | Entry |
|-------|-------|
| Document Number | |
| Document Title | |
| Current Revision | |
## Section 3: Change Description
### Type of Change
- [ ] New Document
- [ ] Revision to Existing Document
- [ ] Document Obsolescence
### Description of Change
*(Describe the proposed change in detail)*
### Reason for Change
*(Explain why this change is needed)*
## Section 4: Impact Assessment
### Affected Areas
- [ ] Training Required
- [ ] Other Documents Affected
- [ ] Process Changes Required
- [ ] Validation Impact
### List Affected Documents
## Section 5: Approvals
| Role | Name | Signature | Date |
|------|------|-----------|------|
| Requester | | | |
| Document Owner | | | |
| Quality Assurance | | | |
---
*Form FRM-001 Rev 1.0*

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# Corrective and Preventive Action (CAPA) Form
| Form ID | FRM-003 | Revision | 1.0 |
|---------|---------|----------|-----|
---
## Section 1: CAPA Identification
| Field | Entry |
|-------|-------|
| CAPA Number | |
| Date Initiated | |
| Initiated By | |
| CAPA Owner | |
| Target Closure Date | |
## Section 2: Classification
### Type
- [ ] Corrective Action
- [ ] Preventive Action
### Source
- [ ] Customer Complaint
- [ ] Internal Audit
- [ ] External Audit
- [ ] Process Deviation
- [ ] Nonconforming Product
- [ ] Management Review
- [ ] Other: ____________
### Priority
- [ ] Critical (5 business days)
- [ ] Major (15 business days)
- [ ] Minor (30 business days)
## Section 3: Problem Description
*(Describe the nonconformity or potential nonconformity)*
## Section 4: Immediate Containment
*(Actions taken to contain the immediate impact)*
## Section 5: Root Cause Investigation
### Investigation Method Used
- [ ] 5 Whys
- [ ] Fishbone Diagram
- [ ] Fault Tree Analysis
- [ ] Other: ____________
### Root Cause Determination
## Section 6: Corrective/Preventive Actions
| Action | Responsible | Due Date | Status |
|--------|-------------|----------|--------|
| | | | |
| | | | |
| | | | |
## Section 7: Effectiveness Verification
| Criteria | Method | Result |
|----------|--------|--------|
| | | |
Verification Date: ____________
Verified By: ____________
## Section 8: Closure
| Role | Name | Signature | Date |
|------|------|-----------|------|
| CAPA Owner | | | |
| Quality Approval | | | |
---
*Form FRM-003 Rev 1.0*

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# Internal Audit Checklist
| Form ID | FRM-006 | Revision | 1.0 |
|---------|---------|----------|-----|
---
## Audit Information
| Field | Entry |
|-------|-------|
| Audit Number | |
| Audit Date | |
| Area/Process Audited | |
| Lead Auditor | |
| Auditee(s) | |
---
## Checklist Items
| # | Requirement/Question | Reference | C/NC/NA | Evidence/Notes |
|---|---------------------|-----------|---------|----------------|
| 1 | Are current versions of applicable procedures available? | SOP-001 | | |
| 2 | Are personnel trained on applicable procedures? | SOP-003 | | |
| 3 | Are training records current and complete? | SOP-003 | | |
| 4 | Are records properly maintained and retrievable? | SOP-001 | | |
| 5 | Are nonconformities being documented and addressed? | SOP-002 | | |
| 6 | Are CAPAs being completed on time? | SOP-002 | | |
| 7 | Is equipment calibrated and maintained? | | | |
| 8 | Are process controls being followed? | | | |
| 9 | Are quality objectives being monitored? | | | |
| 10 | | | | |
**Legend:** C = Conforming, NC = Nonconforming, NA = Not Applicable
---
## Findings Summary
| Finding # | Type | Description | Clause Reference |
|-----------|------|-------------|------------------|
| | | | |
| | | | |
---
## Auditor Signature
| Auditor | Signature | Date |
|---------|-----------|------|
| | | |
---
*Form FRM-006 Rev 1.0*

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# EEG Recording Log
| Form ID | FRM-EEG-001 | Revision | 1.0 |
|---------|-------------|----------|-----|
---
## Patient Information
| Field | Entry |
|-------|-------|
| Patient Name | |
| MRN | |
| Date of Birth | |
| Age | |
| Sex | ☐ Male ☐ Female |
| Study Date | |
| Study Time Start | |
| Study Time End | |
| Study Duration | minutes |
---
## Ordering Information
| Field | Entry |
|-------|-------|
| Ordering Physician | |
| Study Type | ☐ Routine EEG ☐ Sleep-Deprived EEG ☐ Ambulatory EEG ☐ Portable/Bedside ☐ Other: _______ |
| Clinical Indication | |
| Patient Location | ☐ Outpatient Lab ☐ Inpatient Unit: _______ ☐ ICU ☐ ED ☐ OR |
---
## Clinical History
| Field | Entry |
|-------|-------|
| Seizure History | ☐ Yes ☐ No ☐ Unknown |
| Last Seizure Date | |
| Seizure Type | ☐ Generalized ☐ Focal ☐ Unknown |
| Seizure Description | |
### Current Medications (especially AEDs)
| Medication | Dose | Last Taken |
|------------|------|------------|
| | | |
| | | |
| | | |
| | | |
### Other Relevant History
| Field | Entry |
|-------|-------|
| Brain surgery/lesions | ☐ Yes ☐ No Details: |
| Recent head injury | ☐ Yes ☐ No |
| Developmental delay | ☐ Yes ☐ No |
| Psychiatric history | ☐ Yes ☐ No |
| Previous EEG | ☐ Yes (Date: _______) ☐ No |
---
## Pre-Recording Checklist
| Item | Completed |
|------|-----------|
| Patient identity verified (two identifiers) | ☐ |
| Order verified | ☐ |
| Contraindications reviewed | ☐ |
| Patient/family educated on procedure | ☐ |
| Hair clean, no products | ☐ Yes ☐ No (document): |
| Sleep deprivation completed (if ordered) | ☐ Yes ☐ No ☐ N/A |
| Hours of sleep prior to EEG | hours |
---
## Technical Information
### Equipment
| Field | Entry |
|-------|-------|
| EEG System | |
| Software Version | |
| Amplifier Serial # | |
| Electrode Type | ☐ Disc ☐ Cup ☐ Disposable ☐ Cap |
### Electrode Placement
| Field | Entry |
|-------|-------|
| Placement System | ☐ International 10-20 ☐ 10-10 ☐ Modified (describe) |
| Reference Electrode | |
| Ground Electrode | |
| Additional Electrodes | |
### Impedance Check
| Electrode | Pre (kΩ) | Post (kΩ) |
|-----------|----------|-----------|
| Fp1 | | |
| Fp2 | | |
| F7 | | |
| F3 | | |
| Fz | | |
| F4 | | |
| F8 | | |
| T3/T7 | | |
| C3 | | |
| Cz | | |
| C4 | | |
| T4/T8 | | |
| T5/P7 | | |
| P3 | | |
| Pz | | |
| P4 | | |
| T6/P8 | | |
| O1 | | |
| O2 | | |
| A1/M1 | | |
| A2/M2 | | |
| ECG | | |
| Other: | | |
**All impedances <5 kΩ?** ☐ Yes ☐ No (document exceptions)
---
## Recording Parameters
| Parameter | Setting |
|-----------|---------|
| Sensitivity | µV/mm |
| Low Frequency Filter | Hz |
| High Frequency Filter | Hz |
| Notch Filter | ☐ On (___Hz) ☐ Off |
| Display Speed | mm/sec |
| Sampling Rate | Hz |
### Montages Used
☐ Longitudinal bipolar (double banana)
☐ Transverse bipolar
☐ Referential (average)
☐ Referential (ear)
☐ Other: _______
---
## Activation Procedures
### Hyperventilation
| Field | Entry |
|-------|-------|
| Performed? | ☐ Yes ☐ No |
| If No, reason: | ☐ Medical contraindication ☐ Patient unable ☐ Not ordered |
| Duration | minutes |
| Patient effort | ☐ Good ☐ Fair ☐ Poor |
| Start time | |
| Stop time | |
| EEG changes during HV? | ☐ Yes (describe) ☐ No |
| Clinical symptoms during HV? | ☐ Yes (describe) ☐ No |
| Build-up present? | ☐ Yes ☐ No |
| Resolution after HV? | ☐ Normal ☐ Prolonged |
### Photic Stimulation
| Field | Entry |
|-------|-------|
| Performed? | ☐ Yes ☐ No |
| If No, reason: | |
| Start time | |
| Stop time | |
| Lamp distance | cm |
| Eyes condition | ☐ Closed ☐ Open ☐ Both |
**Frequencies tested and response:**
| Frequency (Hz) | Photic driving? | Photoparoxysmal response? |
|----------------|-----------------|---------------------------|
| 1 | ☐ | ☐ |
| 3 | ☐ | ☐ |
| 5 | ☐ | ☐ |
| 7 | ☐ | ☐ |
| 10 | ☐ | ☐ |
| 13 | ☐ | ☐ |
| 15 | ☐ | ☐ |
| 18 | ☐ | ☐ |
| 20 | ☐ | ☐ |
| 25 | ☐ | ☐ |
| 30 | ☐ | ☐ |
**Photomyoclonic response?** ☐ Yes ☐ No
### Sleep
| Field | Entry |
|-------|-------|
| Sleep achieved? | ☐ Yes ☐ No |
| Sleep stage achieved | ☐ Drowsy ☐ Stage I ☐ Stage II ☐ Deeper |
| Method | ☐ Natural ☐ Sleep-deprived ☐ Sedation (medication: _______) |
| Sleep spindles present? | ☐ Yes ☐ No |
| Vertex waves present? | ☐ Yes ☐ No |
| K-complexes present? | ☐ Yes ☐ No |
---
## Patient State/Behavior During Recording
| State | Time (approximate) |
|-------|-------------------|
| Awake, eyes open | |
| Awake, eyes closed | |
| Drowsy | |
| Asleep | |
### Patient Cooperation
☐ Excellent - fully cooperative
☐ Good - generally cooperative
☐ Fair - some difficulty
☐ Poor - unable to cooperate (describe): _______
---
## Technologist Observations
### Clinical Events During Recording
☐ No clinical events observed
| Time | Event Description | EEG Correlation Noted? |
|------|------------------|------------------------|
| | | ☐ Yes ☐ No |
| | | ☐ Yes ☐ No |
| | | ☐ Yes ☐ No |
### Artifacts Noted
☐ Muscle/EMG
☐ Eye movement/blink
☐ Movement
☐ Electrode/technical
☐ 60 Hz/electrical
☐ ECG
☐ Respiration
☐ Sweat
☐ Other: _______
### Preliminary Observations (not interpretation)
☐ Symmetric background
☐ Asymmetric background
☐ Slowing noted
☐ Sharp waveforms noted
☐ Seizure activity observed
☐ Other findings: _______
---
## Technical Quality Assessment
| Criterion | Met? |
|-----------|------|
| Adequate duration (≥20 min) | ☐ Yes ☐ No |
| Acceptable impedances | ☐ Yes ☐ No |
| Multiple montages recorded | ☐ Yes ☐ No |
| Activation procedures completed | ☐ Yes ☐ N/A |
| Sleep recorded (if ordered) | ☐ Yes ☐ N/A |
| Minimal artifact | ☐ Yes ☐ No |
| Calibration documented | ☐ Yes ☐ No |
**Overall Technical Quality:** ☐ Excellent ☐ Good ☐ Fair ☐ Poor
---
## Post-Recording
| Field | Entry |
|-------|-------|
| Electrodes removed | ☐ Yes |
| Scalp inspected | ☐ Normal ☐ Irritation noted: |
| Patient discharged from lab | Time: |
| Patient condition at discharge | ☐ Baseline ☐ Changed (describe): |
| Study uploaded to reading system | ☐ Yes |
| Priority | ☐ Routine ☐ Urgent ☐ STAT |
---
## Technologist Attestation
| Field | Entry |
|-------|-------|
| Technologist Name | |
| Credentials | |
| Signature | |
| Date | |
| Time | |
---
## Physician Review (if immediate review)
| Field | Entry |
|-------|-------|
| Reviewed By | |
| Date/Time | |
| Preliminary Impression | |
| Signature | |
---
*Form FRM-EEG-001 Rev 1.0 - EEG Recording Log*

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# Training Record Form
| Form ID | FRM-004 | Revision | 1.0 |
|---------|---------|----------|-----|
---
## Section 1: Employee Information
| Field | Entry |
|-------|-------|
| Employee Name | |
| Employee ID | |
| Department | |
| Job Title | |
## Section 2: Training Information
| Field | Entry |
|-------|-------|
| Training Title | |
| Training Date | |
| Training Duration | |
| Trainer Name | |
| Trainer Qualification | |
### Training Type
- [ ] Initial Training
- [ ] Retraining
- [ ] Refresher
- [ ] Procedure Update
### Delivery Method
- [ ] Classroom
- [ ] On-the-Job
- [ ] Self-Study
- [ ] Computer-Based
- [ ] Other: ____________
## Section 3: Training Content
*(List topics covered or attach training materials)*
## Section 4: Assessment
### Assessment Method
- [ ] Written Test
- [ ] Practical Demonstration
- [ ] Verbal Assessment
- [ ] Observation
### Assessment Results
| Metric | Result |
|--------|--------|
| Score (if applicable) | |
| Pass/Fail | |
## Section 5: Signatures
| Role | Name | Signature | Date |
|------|------|-----------|------|
| Trainee | | | |
| Trainer | | | |
| Supervisor | | | |
---
*Form FRM-004 Rev 1.0*