Run Voice and Resonance Instrumental Assessment Preparation Checklist — Free

Order, Indication, and Patient Identification

Patient identity verified using two identifiers critical (required)

Confirm the patient using two approved identifiers and match them to the order and chart.

Yes No N/A

Instrumental assessment order and indication confirmed critical (required)

Confirm the requested study type, clinical indication, and referring provider instructions.

Yes No N/A

Procedure type selected critical (required)

Select the planned assessment modality.

Relevant history reviewed for contraindications or precautions

Review documented precautions such as severe respiratory distress, inability to tolerate endoscopic procedure, or other factors affecting readiness.

Yes No N/A

Baseline diagnosis or working clinical question documented

Document the clinical question guiding the assessment, such as dysphonia, resonance disorder, or treatment follow-up.

Consent and Patient Readiness

Procedure explained in understandable terms critical (required)

Explain the purpose, expected sensations, and general steps of the assessment using patient-appropriate language.

Yes No N/A

Informed consent obtained and documented critical (required)

Confirm signed or otherwise documented consent is present before proceeding.

Yes No N/A

Patient able to cooperate with voice tasks and positioning critical (required)

Assess whether the patient can follow directions for sustained phonation, pitch changes, reading tasks, and positioning as needed.

Yes No N/A

Nasal and throat preparation reviewed if applicable

Confirm any required pre-procedure steps, such as topical preparation or fasting instructions, were followed per local protocol.

Yes No N/A

Current symptoms or tolerance concerns documented

Document symptoms that may affect the exam, such as cough, congestion, pain, anxiety, gag sensitivity, or shortness of breath.

Note (optional)

Equipment and Room Readiness

Videostroboscopy or acoustic analysis equipment powered on and functional critical (required)

Confirm the selected system boots normally, displays correctly, and is ready for use without error messages.

Yes No N/A

Camera, light source, microphone, and recording components available critical (required)

Verify all required components for the selected modality are present, connected, and operational.

Yes No N/A

Disposable or patient-contact supplies available and within date

Confirm required supplies such as covers, disposables, and cleaning materials are available and not expired.

Yes No N/A

Equipment cleaning and disinfection completed per protocol critical (required)

Verify the device and patient-contact surfaces were cleaned and disinfected according to facility policy and manufacturer instructions.

Yes No N/A

Room setup supports safe and uninterrupted assessment

Confirm seating, patient access, privacy, and cable management are adequate for the procedure.

Yes No N/A

Baseline Voice Measures

Baseline conversational voice quality documented

Record observed voice quality, including roughness, breathiness, strain, pitch, loudness, and resonance as applicable.

Sustained vowel sample obtained critical (required)

Capture a sustained vowel sample for baseline comparison and analysis.

Yes No N/A

Standard speech sample obtained

Obtain a reading passage or connected speech sample suitable for the planned analysis.

Yes No N/A

Baseline acoustic measures recorded

Enter baseline acoustic data collected before or during the assessment.

Safety, Documentation, and Completion

Any adverse response or intolerance documented critical (required)

Document coughing, distress, vasovagal symptoms, or inability to complete the assessment, if present.

Yes No N/A

Findings and next steps communicated to care team

Record whether preliminary findings, limitations, and follow-up recommendations were communicated according to workflow.

Yes No N/A

Inspector signature critical (required)

Sign to confirm the checklist was completed accurately.

Note (optional)

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Run: Voice and Resonance Instrumental Assessment Preparation Checklist

Order, Indication, and Patient Identification

Consent and Patient Readiness

Equipment and Room Readiness

Baseline Voice Measures

Safety, Documentation, and Completion

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