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Marisela Krajcik
DOX1280 OPAS 1959 PWD

93 yrs (8/7/1931)

047185088890 / 0759755945

marisela_krajcik@example.com

NHS Number: 5665081159

Demographics missing

HIV and AIDS related dementia, diagnosed May 2024

AA: Not discussed

Council tax: Applied/applying

Driving: Informed and driving

Blue badge: Does not currently meet threshold

Health & wellbeing LPA: Not discussed

Property & finance LPA: Applied/applying

edit

This profile has more than 1 open Admiral Nurse case.

Number	Completed at
6	19th Oct 2024	edit
5	4th Apr 2024	edit
4	30th Sep 2023	edit
3	16th Mar 2023	edit
2	11th Sep 2022	edit
1	3rd Mar 2022	edit

Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Marisela Krajcik (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.

Marisela Krajcik DOX1280 OPAS 1959 PWD

Safeguarding Concern Form About the concern

Marisela Krajcik
DOX1280 OPAS 1959 PWD

Safeguarding Concern Form

About the concern