Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Tracer information

  • Do you know the name of your child's primary therapist at the clinic?

  • Do you feel welcome to actively participate in your child's treatment?

  • Have you had information and/or observations concerning your child's that you thought should be communicated to the therapist?

  • When you speak to clinic staff, how well are you listened to?

  • Did you and your child have opportunity to participate in the creation of treatment goals?

  • Do you feel free to discuss what you hope your child will achieve from treatment and to ask questions about treament?

  • If you child is receiving medication treatment, were you fully informed of the risks and benefits of the medication?

  • Has the clinic therapist indicated how you can assist your child meet his/her treatment goals?

  • Do you feel respected by clinic staff?

  • If you had concerns about the services being provided at this clinic, do you know who to contact?

  • Have you ever communicated a concern to the clinic?

  • Do you know who to contact at the clinic during a time of crisis?

  • During times of emerging stress or crisis in your child's condition, does he/she have a safety plan?

  • do you plan any role in the safety plan?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.