Title Page

  • Date

  • Completed by

  • Practice


  • Is the signage well lit, clean and in good location?

  • Are the grounds well maintained and litter free?

  • Are the windows and fascias clean?

  • Windows should only have official MyDentist posters on diplay, is this the case?

  • Are all clinician names advertised and up to date?

  • Please take a photo of the outside (Front) of the building

MyComply & Profit Protection

  • Current MyComply Status

  • Is the practice compliance organised and easy to find?

  • How many days has the practice been Red this quarter?

  • Is there evidence of debt being managed on a daily basis?

  • How many open courses are there?


  • Ask 3 members of the team: do they know who can do Clear Correct? (Nearest MyDentist if none in practice)

  • Ask 3 members of the team: do they know who can do facial aesthetics? (Nearest MyDentist if none in practice)

  • Ask 3 members of the team: do they know who the nearest MyDentist Perio specialist is?

  • Ask 3 members of the team: do they know the cost of a Hygiene appointment including PPE charge?


  • Is there an appropriate fallow time in place between each appointment

  • Is there one appointment slot in the diary today for non-registered emergency patients?

  • Are all clinicians working contracted hours?

  • Is there a SMART diary in place?

  • Are triaging slots in the diary for between 15-20 minutes

  • Are there any questions about the agreement amendments?


  • Are COVID-19 Visitor Measures in place? Sanitizer, temperature checks etc.?

  • Is the inside of the window clean and cluter free?

  • Are there adequate screens to protect reception team?

  • Is there appropriate space behind reception? eg. Not overcrowded

  • Are all staff in uniform?

  • Are all staff wearing name badges?

  • Is the reception area clean and litter free?

  • Are telephones audibly ringing? (Not on mute)

  • Are Oral Health Products on display and priced up correctly?

  • Are all wall posters appropriate, in date, straight, attached properly?

  • Is all signage professional and appropriate?

  • Please take a photo of the reception area

  • Is any confidential waste on display/in waste bin/under counter? PLEASE CHECK ALL BINS IN PUBLIC AREAS AND BEHIND RECEPTION DESK.

  • Are the staff aware of how many emergency appointment slots are available today?

  • Are reception team able to explain benefits of capturing a patients email address?

  • Are reception team able to explain costs of MyOptions appointments?

  • Do the reception team know when the next practice meeting is?

  • Are all areas in reception clean and dust free? Eg floors, corners, posters, shelves, computer terminals, entrance, etc.

Staff room/area

  • Is the staff kitchen clean? Please check sink, fridge, floor, microwave etc.

  • Is the latest insurance document present?

  • Is there an up to date HASAWA poster present

  • Are staff breaks staggered to avoid overcrowding?

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.