Get Ecog-acrin E4112 - Quality Assurance Review Center - Qarc

Filling out the ECOG-ACRIN E4112 form is a crucial step in the quality assurance process for radiation oncology. This guide provides comprehensive instructions on how to complete the form accurately and effectively, ensuring all necessary information is submitted correctly.

Follow the steps to complete the form accurately and efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the patient's initials in the designated field. This information is essential for associating the submission with the respective patient.
3. Provide the registration number assigned to the patient. This helps in tracking and processing the documents correctly.
4. Fill in the sender’s name to indicate who is submitting the materials. This is important for follow-up communication.
5. Input the radiation therapy start date. This date is crucial for evaluating the timeline of care.
6. Enter the sender's phone number and email address for easy communication regarding the submission.
7. Include the name and email of the radiation oncologist to ensure clear identification of the medical professional overseeing the treatment.
8. Ensure you enclose a copy of the checklist with all submitted RT materials. Label all materials with the protocol and assigned registration number.
9. Submit digital treatment plans, screenshots, and diagnostic imaging via sFTP or CD. If using sFTP, email sFTP@qarc.org with the protocol and registration numbers in the subject line.
10. For materials sent via email, contact datasubmission@qarc.org and include the protocol and registration numbers in the subject line.
11. Prepare to submit a postoperative CT if the lumpectomy cavity is not visible on the treatment planning CT within one week of the completion of radiation therapy.
12. Include additional required files such as the digital RT Treatment Plan, Dose Volume Histograms, Digitally Reconstructed Radiographs, and Treatment Planning System Summary Report.
13. Complete the RT-1 Dosimetry Form and the RT Daily Treatment Chart as part of the submission package.
14. Finally, review all fields for accuracy, save changes, and download or print for your records. You may also opt to share the completed form as needed.

Complete your submission of the ECOG-ACRIN E4112 form online to maintain compliance with quality assurance standards.