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Ehtel Marks
DOX1273 OPAS 1952 PWD

83 yrs (29/3/1942)

08116 245822 / 097216853621

ehtel_marks@example.com

NHS Number: 8819269775

Demographics missing

Creutzfeld-Jakob disease (CJD), diagnosed Aug 2024

AA: Declined to apply

Council tax: Not discussed

Driving: Not driving

Blue badge: Declined to apply

Health & wellbeing LPA: Declined to apply

Property & finance LPA: Advice given

edit

Number	Completed at
5	28th Nov 2024	edit
4	27th May 2024	edit
3	23rd Nov 2023	edit
2	3rd May 2023	edit
1	23rd Oct 2022	edit

Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Ehtel Marks (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?

Demo: This is a demo site. Please only enter fake data into this site. Data may be reset at any point.

Ehtel Marks DOX1273 OPAS 1952 PWD

Safeguarding Concern Form About the concern

Ehtel Marks
DOX1273 OPAS 1952 PWD

Safeguarding Concern Form

About the concern