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Kerry Mayert
DOX1626 OPAS 2305 PWD

74 yrs (19/7/1950)

098862196604 / 074313089133

kerry_mayert@example.com

NHS Number: 2131898142

Demographics missing

Mild cognitive impairment, diagnosed May 2024

AA: Application declined

Council tax: Waiting for AA

Driving: Advised to inform

Blue badge: Declined to apply

Health & wellbeing LPA: Not discussed

Property & finance LPA: In place

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Safeguarding Concern Form

About the concern

Page 1 of 2

Safeguarding Concern Form for Kerry Mayert (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.

Kerry Mayert DOX1626 OPAS 2305 PWD

Safeguarding Concern Form About the concern

Kerry Mayert
DOX1626 OPAS 2305 PWD

Safeguarding Concern Form

About the concern