Radiological Audit Data Collection Form - Round 1 Dentist (number) ________ Criteria Case Patient Radiograph View/area Exposure Clinical Grading: Reasons number identified justified recorded evaluation enter recorded 1,2,3,or for 2 or 3 none 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37
Radiological Audit Data Collection Form - Round 1 Dentist (number) ________ Criteria Case number Patient identified Radiograph justified View/area Exposure recorded Clinical evaluation Grading: enter 1,2,3,or none Reasons recorded for 2 or 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37
RA%20R1.docx