This paper deals with the use of a communication audit as a tool for evaluating the effectiveness of public relations within health services. The research was conducted within healthcare institutions operating in the Czech Republic. Areas of research questions were focused on these aspects of health services: The approach to the implementation of a communication audit: Is the communication audit tied to the level of public relations effectiveness evaluation? Is the approach influenced by public relations staff specialization? Is the approach affected by the type of health services according to the typology defined by the Institute of Health Information and Statistics of the Czech Republic? Can we consider the health services communication audit usable? For Health services who stated that they implement a communication audit, further research was focused on reporting audit results, linking the budget with results of the audit, the auditor's relationship with the rated entity, and the criteria for an effective audit. Related hypotheses were tested statistically and the approaches to the implementation of the communication audit were clustered using the Ward cluster analysis. Research has identified three levels of approach of health services to implementation of the audit. These were the variables used for determining the levels: audit outputs of health services, relation to the public relations budget, the person conducting the audit and the typical characteristics of audit realization. Small commitment is evidenced by the public relations executives, by which a lack of interest has been identified and to some extent, ignorance of standards for implementation of a communication audit.