Section 1 (continued)
Please advise if you are maintained in whole or in part by public funds or endowment
Yes  No
If so, please provide brief details, including percentage split of funds received
  a) Government / Public
  
  b) Private Funding
  
  c) Charity Donations
  
What percentage of your patients are
  a) Government / Public
%
  b) Private Funding
%
  c) Charity Donations
%
 
7. Please advise how patients / clients are referred and by whom?
 
8. Please provide details of your premises
  a) Number of floors
  b) Number of rooms
  c) Age of structure
   d) Was the premises erected for the purpose or has it been converted for present use, if so when?
  
  e) Distance to nearest fire station
miles
   f) Details of hydrants, extinguishers, sprinklers, fire exits, including the date of the last inspection undertaken by a qualified consultant or fire officer of the equipment /procedures set in place
  
  g) Are direct phone links to the Fire Brigade installed?
Yes  No
   h) Are all staff, including part time and temporary / contract staff, instructed in the fire protection procedures?
Yes  No
   i) When was the last time that you carried out a fire practise and how often are these carried out
  
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