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Collette Kulas
DOX1089 OPAS 1768 PWD

89 yrs (26/8/1935)

0888992603 / 0780652603

collette_kulas@example.com

NHS Number: 3445701555

Lives alone

Demographics missing

Other, diagnosed Jul 2024

AA: Advised to apply

Council tax: Not discussed

Driving: Awaiting assessment

Blue badge: Granted

Health & wellbeing LPA: Not discussed

Property & finance LPA: Alternative in place

edit

1 ended relationship: Tinisha Effertz (professional carer)

Number	Completed at
	24th Apr	edit
6	25th Dec 2024	edit
5	22nd Jun 2024	edit
4	3rd Dec 2023	edit
3	5th May 2023	edit
2	1st Nov 2022	edit
1	8th Apr 2022	edit

Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Collette Kulas (the "Subject")

Summary of concern

Factual account of what was said or observed. Include dates, times and locations, the person's own words, descriptions of signs/symptoms etc. Refer to Policy for full guidance on recording.

Summary of any immediate actions taken

Eg. Were emergency services called? Any practical support offered etc.

Does the subject have care and support needs?

Eg. Physical or mental health condition

Notes about care and support needs

Do you feel the subject is able to make their own decisions about what happens next?

Notes about decision capabilities

What support / outcome does the subject want?

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Collette Kulas DOX1089 OPAS 1768 PWD

Safeguarding Concern Form About the concern

Collette Kulas
DOX1089 OPAS 1768 PWD

Safeguarding Concern Form

About the concern