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Received Ref Name Stage
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Process referral #208 for Amos Gislason
Triage

Referral received at 9:02am on Tue 8th Apr, 2025
Person with Dementia
MR Amos Gislason 72yrs Male
056220886029 / 0987040075 amos_gislason@example.com 5298 Wenona Cove, Apt. 336, North Shae, XM89 4EE
Preferred contact times: morning
Odio ducimus ipsam cum magnam quibusdam repudiandae unde.
DOB
11/2/1953
NHS
0684648334
GP
Bednar Oval Practice
Ethnic group
Unknown
Diagnosis
Referral made to memory clinic: No (Appointment date: 19/6/2024)
Creutzfeld-Jakob disease (CJD)
Diagnosing clinician: Sherry Morar
20/5/2022
Sensory impairment: Dolor nam voluptatibus cum dolores maiores debitis fuga.
Referral reason
Social activities / isolation
Physical / mobility
Financial / allowances & benefits
Legal / LPA & Wills
Safety in the home
Dementia information
Support for carer / respite
Personal care
Insight
Cognitive ability
Health & wellbeing
Planning for the future
Assistive technology
Aide-memoire
Support for Memory Clinic appointment
Other
Additional notes
This is some text written by the referrer about the pwd's situation.
Carer
-
Referrer
Tien Schuppe Corporis sequi illo odit adipisci perspiciatis fuga.
02030 242187 / 09770 462458 tien_schuppe@example.com
Referral source
Community Club

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