CLINICAL EXAM & REPEAT LOG

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Presentation transcript:

CLINICAL EXAM & REPEAT LOG REVISED JULY 2011 Student Name _______________________________________________________ Clinical Site ___________________________________________ Exam Performed Reason for Repeat (Enter Letter or Appropriate Reason) Registered Technologist (Initial and check appropriate Category) Date MR Number Exam Image Repeated P = Positioning, T = Technique, C = Collimation E = Equipment Initials Observed Assisted Performed Appendix G: Clinical Exam and Repeat Log

Clinical Director Signature Student Acknowledgment of Repeat Exam Supervision and Use of the Clinical Exam/Repeat Log I,____________ ________, acknowledge that I have received and fully understand the policies regarding supervision during repeat examinations and use of the Clinical Exam and Repeat Log. I understand and accept that a registered technologist must initial every exam and that repeat examinations require the direct supervision (physical presence) of a registered technologist. I am required to upload the Clinical Exam/Repeat Log and Clinical Time Sheet to my extern course every week that I have a clinical assignment . Steve Forshier Clinical Director Signature Student Signature Date Appendix G: Clinical Exam and Repeat Log