Centre for Radiography Education
School of Health Sciences and Social Work
University of Portsmouth
Clinical Visit Report
Part A – To be completed by the prospective student
Name…………………………………………….. UCAS No………………………………..
Hospital Visited………………………………………………………………........................
Diagnostic or Therapeutic Department……………………………………………………
Date(s) of visit……………………..
Length of time spent in the Department…………………………………………
Types of examinations/treatments the applicant observed:
…………………………………………………………………………………………………………….
…………………………………………………………………………………………………………….
…………………………………………………………………………………………………………….
…………………………………………………………………………………………………………….
…………………………………………………………………………………………………………….
Part B – To be completed by the supervising radiographer
Dear Colleague
Thank you for allowing one of our prospective students to visit your department. As part of the
selection process to undertake a BSc (Hons) degree in Radiography we strongly recommend that
applicants should spend a period of time in the clinical department. We should therefore be very
grateful for your comments on the suitability of the applicant for a career in Radiography. The
completed form can either be given back to the applicant, or if you prefer the report to remain
confidential, post it directly back to me at the address below. Thank you for your assistance.
Variety of patients seen, (e.g. accident and emergency, paediatrics and elderly care):
……………………………………………………………………………………………………………..
…………………………………………………………………………………………………………….
Range of tasks applicant actively involved in (i.e. assisting in changing patients, passing
equipment/cassettes to clinical staff):
………………………………………………………………………………………………………………
……………………………………………………………………………………………………………..
Signature & Name of Radiographer…………………………………………………………… ………
Post Held…………………………………………………………………………..................................
Telephone Number……………………………………………………………………...
Please return this form to the applicant or to:
Science Admissions Team
Floor 3, Hippodrome House
Guildhall Walk
Portsmouth
Hampshire
PO1 2RY
THANK YOU FOR YOUR ASSISTANCE