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QA checklist Please review the table below. For the QA that your clinic performs, you need to at least observe the procedure. If you are able to assist or perform any of the followirig procedures, that's even better! At the completion of the 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 of the QA course, so they are able to help get you involved in as much QA as possible. ‘Type of QA Observed Assisted | Daily Warm-up QA for Linae x Daily Warm-up QA for CT Simulator x Monthly Linae Monthly CT Simulator IMRT SRS Brachytherapy Respiratory Gating* IGRT system Treatment Planning System ice | ee accep [isa cana YLGb Preceptor signature Date *If Respiratory gating is not performed in your clinic, research this topic and provide a short summary of the QA to be performed along with the current tolerances,

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