Engineering Survey

Find out where your equipment stands.

Tell us about the practice and what prompted the request. We will confirm the scope and a date with you directly.

The survey is a visual and functional review of the major equipment in your practice, written up as a clear list of priorities. It is not a statutory inspection or a compliance audit.

Please do not include patient information.

This form is for equipment and practice details only. Do not enter patient names, clinical notes or any other patient-identifiable information, and do not upload images that show patients.

The practice

Practice name

Practice postcode

Address (optional)

Number of surgeries (optional)

You

Your name

Email address

Telephone

Best time to call (optional)

For example, Tuesday afternoons.

The survey

What prompted the request? (optional)

Anything we should know? (optional)

Major equipment, known problems, access or timing constraints.

How should we reply?

Telephone Email Either

I have read the privacy notice and I am not sending patient or clinical information.

Sending this form requests a survey. It is not booked until we have confirmed the scope and date with you.