diff --git a/CHANGELOG.md b/CHANGELOG.md
index 5238d7b5..01134020 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -7,6 +7,10 @@ and this project adheres to [Semantic Versioning](https://semver.org/spec/v2.0.0
 ## [Unreleased]
 
 
+## Added
+
+- FoDicomAnonymiser checks now support automatic database creation/patching for UID mapping server
+
 ## [2.2.4] 2021-03-08
 
 ### Changed
diff --git a/Rdmp.Dicom.Tests/Integration/FoDicomAnonymiserTests.cs b/Rdmp.Dicom.Tests/Integration/FoDicomAnonymiserTests.cs
index 29b4a971..b4ecc3d1 100644
--- a/Rdmp.Dicom.Tests/Integration/FoDicomAnonymiserTests.cs
+++ b/Rdmp.Dicom.Tests/Integration/FoDicomAnonymiserTests.cs
@@ -238,7 +238,29 @@ public void TestPutDicomFilesInExtractionDirectories(Type putterType)
 
         }
 
+        
+        [Test]
+        public void TestUIDTableExists()
+        {
+            var db = GetCleanedServer(DatabaseType.MicrosoftSQLServer);
+
+            // set it to an empty database
+            var eds = new ExternalDatabaseServer(CatalogueRepository,"UID server",null);
+            eds.SetProperties(db);
+
+            var anon = new FoDicomAnonymiser();
+            anon.UIDMappingServer = eds;
+
+            var ex = Assert.Throws<Exception>(()=>anon.Check(new ThrowImmediatelyCheckNotifier() { ThrowOnWarning = true }));
+
+            StringAssert.AreEqualIgnoringCase("UIDMappingServer is not set up yet", ex.Message);
 
+            anon.Check(new AcceptAllCheckNotifier());
+
+            // no warnings after it has been created
+            Assert.DoesNotThrow(() => anon.Check(new ThrowImmediatelyCheckNotifier() { ThrowOnWarning = true }));
+
+        }
 
         private IExtractDatasetCommand MockExtractionCommand()
         {
@@ -262,5 +284,6 @@ private IExtractDatasetCommand MockExtractionCommand()
 
             return cmd;
         }
+
     }
 }
diff --git a/Rdmp.Dicom/Extraction/FoDicomBased/FoDicomAnonymiser.cs b/Rdmp.Dicom/Extraction/FoDicomBased/FoDicomAnonymiser.cs
index 0e61bd36..80f1f07b 100644
--- a/Rdmp.Dicom/Extraction/FoDicomBased/FoDicomAnonymiser.cs
+++ b/Rdmp.Dicom/Extraction/FoDicomBased/FoDicomAnonymiser.cs
@@ -12,6 +12,7 @@
 using Rdmp.Core.DataFlowPipeline.Requirements;
 using Rdmp.Core.DataFlowPipeline;
 using Rdmp.Core.Repositories.Construction;
+using MapsDirectlyToDatabaseTable.Versioning;
 
 namespace Rdmp.Dicom.Extraction.FoDicomBased
 {
@@ -183,9 +184,55 @@ public void PreInitialize(IExtractCommand value, IDataLoadEventListener listener
             _extractCommand = value as IExtractDatasetCommand;
         }
 
+        private static object CreateServersOneAtATime = new object();
+
         public void Check(ICheckNotifier notifier)
         {
-            
+            lock(CreateServersOneAtATime)
+            {
+                if (UIDMappingServer == null)
+                {
+                    throw new Exception($"{nameof(UIDMappingServer)} not set, set it existing UID mapping server or to an empty database to create a new one");
+                }
+
+                var patcher = new SMIDatabasePatcher();
+
+                if (!UIDMappingServer.WasCreatedBy(patcher))
+                {
+                    if (string.IsNullOrWhiteSpace(UIDMappingServer.CreatedByAssembly))
+                    {
+                        bool create = notifier.OnCheckPerformed(new CheckEventArgs($"{nameof(UIDMappingServer)} is not set up yet", CheckResult.Warning, null, "Attempt to create UID mapping schema"));
+
+                        if (create)
+                        {
+                            var db = UIDMappingServer.Discover(ReusableLibraryCode.DataAccess.DataAccessContext.DataExport);
+
+                            if (!db.Exists())
+                            {
+                                notifier.OnCheckPerformed(new CheckEventArgs($"About to create {db}", CheckResult.Success));
+                                db.Create();
+                            }
+
+                            notifier.OnCheckPerformed(new CheckEventArgs($"Creating UID Mapping schema in {db}", CheckResult.Success));
+
+                            var scripter = new MasterDatabaseScriptExecutor(db);
+                            scripter.CreateAndPatchDatabase(patcher, new AcceptAllCheckNotifier());
+
+                            UIDMappingServer.CreatedByAssembly = patcher.Name;
+                            UIDMappingServer.SaveToDatabase();
+                        }
+                        else
+                        {
+                            return;
+                        }
+                    }
+                    else
+                    {
+                        notifier.OnCheckPerformed(new CheckEventArgs($"{nameof(UIDMappingServer)} '{UIDMappingServer}' was created by '{UIDMappingServer.CreatedByAssembly}' not a UID patcher.  Try creating a new server reference to a blank database", CheckResult.Fail));
+                        return;
+                    }
+                }
+            }
         }
     }
 }