Sync template from atomicqms-style deployment
This commit is contained in:
0
Forms/Equipment-Records/.gitkeep
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0
Forms/Equipment-Records/.gitkeep
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64
Forms/FRM-001-Document-Change-Request.md
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64
Forms/FRM-001-Document-Change-Request.md
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# Document Change Request Form
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| Form ID | FRM-001 | Revision | 1.0 |
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|---------|---------|----------|-----|
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---
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## Section 1: Request Information
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| Field | Entry |
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|-------|-------|
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| Request Date | |
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| Requested By | |
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| Department | |
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## Section 2: Document Information
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| Field | Entry |
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|-------|-------|
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| Document Number | |
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| Document Title | |
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| Current Revision | |
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## Section 3: Change Description
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### Type of Change
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- [ ] New Document
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- [ ] Revision to Existing Document
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- [ ] Document Obsolescence
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### Description of Change
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*(Describe the proposed change in detail)*
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### Reason for Change
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*(Explain why this change is needed)*
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## Section 4: Impact Assessment
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### Affected Areas
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- [ ] Training Required
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- [ ] Other Documents Affected
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- [ ] Process Changes Required
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- [ ] Validation Impact
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### List Affected Documents
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## Section 5: Approvals
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| Role | Name | Signature | Date |
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|------|------|-----------|------|
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| Requester | | | |
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| Document Owner | | | |
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| Quality Assurance | | | |
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---
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*Form FRM-001 Rev 1.0*
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91
Forms/FRM-003-CAPA-Form.md
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Forms/FRM-003-CAPA-Form.md
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# Corrective and Preventive Action (CAPA) Form
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| Form ID | FRM-003 | Revision | 1.0 |
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|---------|---------|----------|-----|
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---
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## Section 1: CAPA Identification
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| Field | Entry |
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|-------|-------|
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| CAPA Number | |
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| Date Initiated | |
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| Initiated By | |
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| CAPA Owner | |
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| Target Closure Date | |
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## Section 2: Classification
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### Type
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- [ ] Corrective Action
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- [ ] Preventive Action
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### Source
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- [ ] Customer Complaint
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- [ ] Internal Audit
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- [ ] External Audit
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- [ ] Process Deviation
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- [ ] Nonconforming Product
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- [ ] Management Review
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- [ ] Other: ____________
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### Priority
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- [ ] Critical (5 business days)
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- [ ] Major (15 business days)
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- [ ] Minor (30 business days)
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## Section 3: Problem Description
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*(Describe the nonconformity or potential nonconformity)*
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## Section 4: Immediate Containment
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*(Actions taken to contain the immediate impact)*
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## Section 5: Root Cause Investigation
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### Investigation Method Used
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- [ ] 5 Whys
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- [ ] Fishbone Diagram
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- [ ] Fault Tree Analysis
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- [ ] Other: ____________
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### Root Cause Determination
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## Section 6: Corrective/Preventive Actions
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| Action | Responsible | Due Date | Status |
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|--------|-------------|----------|--------|
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| | | | |
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| | | | |
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| | | | |
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## Section 7: Effectiveness Verification
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| Criteria | Method | Result |
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|----------|--------|--------|
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| | | |
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Verification Date: ____________
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Verified By: ____________
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## Section 8: Closure
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| Role | Name | Signature | Date |
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|------|------|-----------|------|
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| CAPA Owner | | | |
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| Quality Approval | | | |
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---
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*Form FRM-003 Rev 1.0*
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Forms/FRM-006-Audit-Checklist.md
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Forms/FRM-006-Audit-Checklist.md
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# Internal Audit Checklist
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| Form ID | FRM-006 | Revision | 1.0 |
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|---------|---------|----------|-----|
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---
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## Audit Information
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| Field | Entry |
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|-------|-------|
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| Audit Number | |
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| Audit Date | |
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| Area/Process Audited | |
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| Lead Auditor | |
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| Auditee(s) | |
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---
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## Checklist Items
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| # | Requirement/Question | Reference | C/NC/NA | Evidence/Notes |
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|---|---------------------|-----------|---------|----------------|
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| 1 | Are current versions of applicable procedures available? | SOP-001 | | |
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| 2 | Are personnel trained on applicable procedures? | SOP-003 | | |
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| 3 | Are training records current and complete? | SOP-003 | | |
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| 4 | Are records properly maintained and retrievable? | SOP-001 | | |
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| 5 | Are nonconformities being documented and addressed? | SOP-002 | | |
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| 6 | Are CAPAs being completed on time? | SOP-002 | | |
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| 7 | Is equipment calibrated and maintained? | | | |
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| 8 | Are process controls being followed? | | | |
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| 9 | Are quality objectives being monitored? | | | |
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| 10 | | | | |
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**Legend:** C = Conforming, NC = Nonconforming, NA = Not Applicable
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---
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## Findings Summary
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| Finding # | Type | Description | Clause Reference |
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|-----------|------|-------------|------------------|
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| | | | |
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| | | | |
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---
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## Auditor Signature
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| Auditor | Signature | Date |
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|---------|-----------|------|
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| | | |
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---
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*Form FRM-006 Rev 1.0*
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0
Forms/Infection-Control/.gitkeep
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0
Forms/Infection-Control/.gitkeep
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316
Forms/Recording-Logs/FRM-EEG-001-Recording-Log.md
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316
Forms/Recording-Logs/FRM-EEG-001-Recording-Log.md
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# EEG Recording Log
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| Form ID | FRM-EEG-001 | Revision | 1.0 |
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|---------|-------------|----------|-----|
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---
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## Patient Information
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| Field | Entry |
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|-------|-------|
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| Patient Name | |
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| MRN | |
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| Date of Birth | |
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| Age | |
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| Sex | ☐ Male ☐ Female |
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| Study Date | |
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| Study Time Start | |
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| Study Time End | |
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| Study Duration | minutes |
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---
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## Ordering Information
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| Field | Entry |
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|-------|-------|
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| Ordering Physician | |
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| Study Type | ☐ Routine EEG ☐ Sleep-Deprived EEG ☐ Ambulatory EEG ☐ Portable/Bedside ☐ Other: _______ |
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| Clinical Indication | |
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| Patient Location | ☐ Outpatient Lab ☐ Inpatient Unit: _______ ☐ ICU ☐ ED ☐ OR |
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---
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## Clinical History
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| Field | Entry |
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|-------|-------|
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| Seizure History | ☐ Yes ☐ No ☐ Unknown |
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| Last Seizure Date | |
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| Seizure Type | ☐ Generalized ☐ Focal ☐ Unknown |
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| Seizure Description | |
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### Current Medications (especially AEDs)
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| Medication | Dose | Last Taken |
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|------------|------|------------|
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| | | |
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| | | |
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| | | |
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| | | |
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### Other Relevant History
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| Field | Entry |
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|-------|-------|
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| Brain surgery/lesions | ☐ Yes ☐ No Details: |
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| Recent head injury | ☐ Yes ☐ No |
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| Developmental delay | ☐ Yes ☐ No |
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| Psychiatric history | ☐ Yes ☐ No |
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| Previous EEG | ☐ Yes (Date: _______) ☐ No |
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---
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## Pre-Recording Checklist
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| Item | Completed |
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|------|-----------|
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| Patient identity verified (two identifiers) | ☐ |
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| Order verified | ☐ |
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| Contraindications reviewed | ☐ |
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| Patient/family educated on procedure | ☐ |
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| Hair clean, no products | ☐ Yes ☐ No (document): |
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| Sleep deprivation completed (if ordered) | ☐ Yes ☐ No ☐ N/A |
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| Hours of sleep prior to EEG | hours |
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---
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## Technical Information
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### Equipment
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| Field | Entry |
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|-------|-------|
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| EEG System | |
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| Software Version | |
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| Amplifier Serial # | |
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| Electrode Type | ☐ Disc ☐ Cup ☐ Disposable ☐ Cap |
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### Electrode Placement
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| Field | Entry |
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|-------|-------|
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| Placement System | ☐ International 10-20 ☐ 10-10 ☐ Modified (describe) |
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| Reference Electrode | |
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| Ground Electrode | |
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| Additional Electrodes | |
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### Impedance Check
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| Electrode | Pre (kΩ) | Post (kΩ) |
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|-----------|----------|-----------|
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| Fp1 | | |
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| Fp2 | | |
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| F7 | | |
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| F3 | | |
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| Fz | | |
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| F4 | | |
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| F8 | | |
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| T3/T7 | | |
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| C3 | | |
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| Cz | | |
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| C4 | | |
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| T4/T8 | | |
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| T5/P7 | | |
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| P3 | | |
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| Pz | | |
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| P4 | | |
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| T6/P8 | | |
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| O1 | | |
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| O2 | | |
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| A1/M1 | | |
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| A2/M2 | | |
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| ECG | | |
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| Other: | | |
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**All impedances <5 kΩ?** ☐ Yes ☐ No (document exceptions)
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---
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## Recording Parameters
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| Parameter | Setting |
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|-----------|---------|
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| Sensitivity | µV/mm |
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| Low Frequency Filter | Hz |
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| High Frequency Filter | Hz |
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| Notch Filter | ☐ On (___Hz) ☐ Off |
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| Display Speed | mm/sec |
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| Sampling Rate | Hz |
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### Montages Used
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☐ Longitudinal bipolar (double banana)
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☐ Transverse bipolar
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☐ Referential (average)
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☐ Referential (ear)
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☐ Other: _______
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---
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## Activation Procedures
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### Hyperventilation
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| Field | Entry |
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|-------|-------|
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| Performed? | ☐ Yes ☐ No |
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| If No, reason: | ☐ Medical contraindication ☐ Patient unable ☐ Not ordered |
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| Duration | minutes |
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| Patient effort | ☐ Good ☐ Fair ☐ Poor |
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| Start time | |
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| Stop time | |
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| EEG changes during HV? | ☐ Yes (describe) ☐ No |
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| Clinical symptoms during HV? | ☐ Yes (describe) ☐ No |
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| Build-up present? | ☐ Yes ☐ No |
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| Resolution after HV? | ☐ Normal ☐ Prolonged |
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### Photic Stimulation
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| Field | Entry |
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|-------|-------|
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| Performed? | ☐ Yes ☐ No |
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| If No, reason: | |
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| Start time | |
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| Stop time | |
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| Lamp distance | cm |
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| Eyes condition | ☐ Closed ☐ Open ☐ Both |
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**Frequencies tested and response:**
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| Frequency (Hz) | Photic driving? | Photoparoxysmal response? |
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|----------------|-----------------|---------------------------|
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| 1 | ☐ | ☐ |
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| 3 | ☐ | ☐ |
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| 5 | ☐ | ☐ |
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| 7 | ☐ | ☐ |
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| 10 | ☐ | ☐ |
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| 13 | ☐ | ☐ |
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| 15 | ☐ | ☐ |
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| 18 | ☐ | ☐ |
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| 20 | ☐ | ☐ |
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| 25 | ☐ | ☐ |
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| 30 | ☐ | ☐ |
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**Photomyoclonic response?** ☐ Yes ☐ No
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|
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### Sleep
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| Field | Entry |
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|-------|-------|
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| Sleep achieved? | ☐ Yes ☐ No |
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| Sleep stage achieved | ☐ Drowsy ☐ Stage I ☐ Stage II ☐ Deeper |
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| Method | ☐ Natural ☐ Sleep-deprived ☐ Sedation (medication: _______) |
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| Sleep spindles present? | ☐ Yes ☐ No |
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| Vertex waves present? | ☐ Yes ☐ No |
|
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| K-complexes present? | ☐ Yes ☐ No |
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|
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---
|
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|
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## Patient State/Behavior During Recording
|
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|
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| State | Time (approximate) |
|
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|-------|-------------------|
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| Awake, eyes open | |
|
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| Awake, eyes closed | |
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| Drowsy | |
|
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| Asleep | |
|
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|
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### Patient Cooperation
|
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|
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☐ Excellent - fully cooperative
|
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☐ Good - generally cooperative
|
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☐ Fair - some difficulty
|
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☐ Poor - unable to cooperate (describe): _______
|
||||
|
||||
---
|
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|
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## Technologist Observations
|
||||
|
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### Clinical Events During Recording
|
||||
|
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☐ No clinical events observed
|
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|
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| Time | Event Description | EEG Correlation Noted? |
|
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|------|------------------|------------------------|
|
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| | | ☐ Yes ☐ No |
|
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| | | ☐ Yes ☐ No |
|
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| | | ☐ Yes ☐ No |
|
||||
|
||||
### Artifacts Noted
|
||||
|
||||
☐ Muscle/EMG
|
||||
☐ Eye movement/blink
|
||||
☐ Movement
|
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☐ Electrode/technical
|
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☐ 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*
|
||||
0
Forms/Report-Templates/.gitkeep
Normal file
0
Forms/Report-Templates/.gitkeep
Normal file
0
Forms/Requisition-Forms/.gitkeep
Normal file
0
Forms/Requisition-Forms/.gitkeep
Normal file
0
Forms/Technical-Logs/.gitkeep
Normal file
0
Forms/Technical-Logs/.gitkeep
Normal file
72
Forms/Training/FRM-004-Training-Record.md
Normal file
72
Forms/Training/FRM-004-Training-Record.md
Normal file
@@ -0,0 +1,72 @@
|
||||
# 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*
|
||||
Reference in New Lab Ticket
Block a user