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Audit Format

Centre Name:

Nutritionist Name :

Audit Conducted By

Date of the audit

Summary
Regular Clients No of Files Checked:____________
Overall Comment on files audited (file Updation , filing, recall status, file maintenance)

Packed programme: No of files checked:____________


Overall Comment on files audited- (file Updation , filing, recall status, file maintenance)

Areas of Improvement & Any other comments ( With details)

Signature of Auditor Signature of Auditee


G – 2 Rich a Es ta te, B/ 29, New Link Ro ad, Andhe ri (W), M um ba i – 40 0 0 53
Tel: 022 -2673 2883/ 2673 3001, Fax: 022 – 273 3181,
Website: www.health-total.com
Instructions

• Centers to be intimated in advance on audit dates


• Coordinators will intimate auditors of any special audit agenda, last audit follow ups
• Files should be audited at random including a mix of both new and old client profiles
• Min of 10 files per category ( regular/ packed progarmme)to be audited.
• All observations and corrective action suggested should be noted in the form
• A copy of the summary to be given to the center
• A copy of the previous audit to be carried by the auditors
• A review of last audit minutes to be done before the fresh audit
• All reports to be duly competed and handed over to the coordinator of the Audit.
• Coordinators consolidate reports and circulate
• Coordinators will escalate cases as required to Dr Anjali Mukerjee.

G – 2 Rich a Es ta te, B/ 29, New Link Ro ad, Andhe ri (W), M um ba i – 40 0 0 53


Tel: 022 -2673 2883/ 2673 3001, Fax: 022 – 273 3181,
Website: www.health-total.com
Client Name:_______________________________________ File No.:_________

Programme Joined: Wks completed____

Comments on line of treatment given on the special medical cases/ the health plans
(Eg functional foods are added in cases of hairball, low hb, levels etc)

1. Success of the programme


a. Is weight loss of the clients is as per our set standards Yes No
(500gms for sp case or 700g- 1kg / week) Put comment till date
b. Medical concern raised during the programe attended to. Yes No

2. File Generation
a. Client diet recall taken Yes No
b. Weight, Height ,BMI,Body FAT % mentioned Yes No
c. Ideal Body Weight Ideal Weight range mentioned. Yes No
the target weight loss promised to is mentioned on file Yes No
d. On upgrade a new file is attached to the old Yes No

3. File Maintenance
a. BMI ,BODY FAT% and W:H RATIO on monthly basis Yes No
b. Average weight loss mentioned at the end of every page Yes No
c. Diet codes used are standard. Yes No
d. Diet codes highlighted with orange marker on every visit. Yes No
e. NFD, NDE , GAPS, PERIODS etc are mentioned Yes No
f. Mandatory temporary maintenance given every one month. Yes No
g. Every extension sheet has a number and name of the client Yes No
h. Top of every extension veg or a non veg status mentioned Yes No

4. Packed programme
a. files are well maintained Yes No
b. A good average weight loss is seen Yes No
c. follow ups are done on a weekly basis Yes No
d. Clients are responding Yes No

Corrective Actions taken as per last Audit

G – 2 Rich a Es ta te, B/ 29, New Link Ro ad, Andhe ri (W), M um ba i – 40 0 0 53


Tel: 022 -2673 2883/ 2673 3001, Fax: 022 – 273 3181,
Website: www.health-total.com