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Self-Audit

This form requires completion for students carrying out course related procedures in their own workplace. Students are required to complete all sections noting that in section 20 you are only required to complete the information related to the speciality of the course you are registerered on.

Please ensure you have the following documents to hand before completing this audit

  • Your infection control policy and procedures document
  • A photograph of your current health and safety poster
  • A photograph of your public liability certificate
  • A photograph of your up to date pressure vessel insurance
  • Your radiography QA process
  • Your latest test certificate for radiography equipment
  • Current complaints procedure and policy

1) General

 

2) Practice Details

 

3) Audit Details

 

4) Staffing

 

5) QA Scheme / Clinical Governance

 

6) CQC Details

 

7) Data Protection

 

8) Education Facilities

Do you have…?
 

9) Medical Emergencies

Do you have…?
 

10) Infection Control

Please upload your infection control policy and procedures document below
 

11) Decontamination

 

12) Protective Personal Equipment

 

13) Waste Disposal

Can you provide transfer notes for the last 2 years? (required)
 

14) Health and Safety

Please upload a photograph of your current health and safety poster below
 
Do you have full risk assessment in place?
Please upload a photograph of your public liability certificate below
 
Please upload a photograph of your up to date pressure vessel insurance certificate below
 
 

15) Radiography

Do you have…?
Please upload your radiography QA process below
Please upload a copy of your latest test certificate for radiography equipment below
 
Do you routinely include a report for all radiography in patients’ clinical notes? (required)
 

16) Clinical Photography

Do you have intra-oral mirrors and cheek and lip retractors? (required)
 

17) Record Keeping

Please indicate which of the following you routinely record in the patient’s records
 

18) Complaints

Please upload a copy of your current complaints procedures and policy below
 

19) Document Upload

Please upload the following and tick to confirm (required)
Attach file
No files are currently attached.
 

20) Course Specific Information

 
a) Orthodontics
(Diploma in Orthodontic Therapy and MSc in Orthodontics)
 
Do you use…?
b) MSc Implant Dentistry

 
Do you have…?
 
c) MSc Endodontics

 
 
d) MSc Restorative and Aesthetic Dentistry

 
Do you currently…?
 

Submission

I confirm the information provided on this form is correct at the time of submission and will inform the department should any changes arise
 
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The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.

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