University of Exeter
BSc (Hons) Medical Imaging (Diagnostic Radiography)
Practice Placement Preferences Questionnaire
Questionnaires must be returned by the date specified in order for the preferences expressed here to
be taken into consideration.
Name:
Home
Address:
Term
Address:
With regard to the NHS bursary scheme http://www.nhspa.gov.uk/sgu/
Are you eligible to claim back the cost of travel to your clinical placement site?
Yes / No
Are you eligible to claim back accommodation costs for your clinical placement
(if you have doubled up on accommodation for that period?
Yes / No
Are you entitled to claim back ALL of your placement expenses?
Yes / No
Have you undertaken paid employment within the Imaging / Radiology / X-ray
Department of any of these placement hospitals? If the answer is yes, please
state which hospital here:
Yes / No
Are you being sponsored e.g. by an Imaging / Radiology / X-ray Department
or NHS Trust? If the answer is yes, please state who is sponsoring you here:
Yes / No
Please detail below any additional factors you consider relevant to the
allocation process:
Please refer to the UEMS School Handbook http://uemsvle.exeter.ac.uk/ext/mihb/index.php for
further information about the allocation of placement sites.
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University of Exeter BSc (Hons) Medical Imaging (Diagnostic Radiography)
Please number each of the placement sites below in order of preference, with 1 being the
hospital you would most like to go to, and 10 being the hospital you would least like to go
to.
At least one of your placements must be at a hospital that undertakes major trauma work.
Hospital
Major
Trauma
Barnstaple
Bournemouth
Dorchester
Exeter
Plymouth
No
No
Yes
Yes
Yes
Order of
Preference
Hospital
Major
Trauma
Poole
Taunton
Torbay
Truro
Yeovil
Yes
Yes
No
Yes
Yes
Order of
Preference
Whilst every effort will be made to allocate you the hospitals of your choice, this cannot be
guaranteed, as each hospital has an upper limit for the number of students it can
accommodate. Hence, allocation depends in part on the demand for particular hospitals.
Finally, once the allocations have been made, it may, on occasion, be necessary to make
changes to these allocations. If this is the case, the individual students concerned will be
contacted and the changes discussed. Once a student has started a placement, changes will
only be made if exceptional personal circumstances warrant it – this will be at the discretion
of the Medical School.
Are you in agreement that we can provide the outcome of your CRB Check
to your placement site if your placement site requests this information?
Yes / No
If yes, please sign below.
Signature:
Please sign here to confirm that you agree to attend any of the ten placement hospitals
allocated to you during this programme:
Signature:
Date:
PRINT NAME:
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