(Caesse Quins
QA checklist
Please review the table below. For the QA that your lini performs, you need to atleast observe
the procedure. Ifyou are she to assist or perform any ofthe following procedures, that’s even
Detter! At the completion ofthe Fall QA course, submit the table below leaving an “x” in the
boxes that apply to the procedures that you have observed or participated in and have your
preceptor sign the form. Submit this table to the dropbox by the last day of the course in Fall
Semester. Make sure you mention this assignment to your preceptor or physicist prior to the
Beginning ofthe OA course so they are able to help get you involved in as much OA as possible.
‘Type of OX “Oibsersed [Asst
Warm-up QA for Linae
a
Daily Warm-up QA for CT Simulator
‘Monthly Linae
Monthly CT Simulator
IMRT
KK YE JK IK KPI
SRS
Brachytherapy
Respiratory Gating
IGRT system
FAK
‘Treatment Planning Syst
Le
2/(22
Precept synafare Date
"IF Respiratory gating is not performed in your elni, research ths topic and provide a short
summary ofthe QA to be performed along with the eurrent tolerances.