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Cyrstal Gottlieb
DOX1437 OPAS 2116 PWD

77 yrs (17/1/1948)

09233 609786 / 09719 436257

cyrstal_gottlieb@example.com

NHS Number: 3531058355

Lives alone

Demographics missing

Unknown, diagnosed Feb 2025

AA: Higher rate

Council tax: Applied/applying

Driving: Not driving

Blue badge: Does not currently meet threshold

Health & wellbeing LPA: Applied/applying

Property & finance LPA: Alternative in place

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Activity
Admiral Nurse Case ANC384 Open Manage
DA Case #DC443 Green Manage
Referred to Cruse Bereavement Support Referred Manage

Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Cyrstal Gottlieb (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.

Cyrstal Gottlieb DOX1437 OPAS 2116 PWD

Admiral Nurse Case ANC384 Open

DA Case #DC443 Green

Referred to Cruse Bereavement Support Referred

Safeguarding Concern Form About the concern

Cyrstal Gottlieb
DOX1437 OPAS 2116 PWD

Admiral Nurse Case ANC384
Open

DA Case #DC443
Green

Referred to Cruse Bereavement Support
Referred

Safeguarding Concern Form

About the concern