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Carol White
DOX1332 OPAS 2011 PWD

87 yrs (7/6/1937)

0938248073 / 05248 958740

carol_white@example.com

NHS Number: 2935119967

Demographics missing

HIV and AIDS related dementia, diagnosed Sep 2024

AA: Applied/applying

Council tax: Applied/applying

Driving: Not discussed

Blue badge: Declined to apply

Health & wellbeing LPA: Declined to apply

Property & finance LPA: Alternative in place

edit

Carer

Chi Klein (father-in-law)

DOX1333

OPAS 2012

73 yrs (29/6/1951)

086848661815 / 096058474282

Edit

Number	Completed at
3	2nd Oct 2024	edit
2	28th Mar 2024	edit
1	27th Sep 2023	edit

Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Carol White (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.

Carol White DOX1332 OPAS 2011 PWD

Safeguarding Concern Form About the concern

Carol White
DOX1332 OPAS 2011 PWD

Safeguarding Concern Form

About the concern