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Douglass Pagac
DOX1292 OPAS 1971 PWD

76 yrs (8/6/1948)

0347816076 / 0384407225

douglass_pagac@example.com

NHS Number: 8409124432

Demographics missing

Alzheimer's disease, diagnosed Sep 2024

AA: Applied/applying

Council tax: Declined - No discount

Driving: Advised to inform

Blue badge: Advised to apply

Health & wellbeing LPA: In place

Property & finance LPA: Applied/applying

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Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Douglass Pagac (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.

Douglass Pagac DOX1292 OPAS 1971 PWD

Safeguarding Concern Form About the concern

Douglass Pagac
DOX1292 OPAS 1971 PWD

Safeguarding Concern Form

About the concern