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Received Ref Name Stage
5 months ago #228 Francisco Ankunding Triage View
5 months ago #147 Henry Quitzon Triage View
5 months ago #204 Sam Ledner Triage View
5 months ago #159 Roderick Terry Triage View
5 months ago #136 Forrest Langworth Triage View
5 months ago #170 Porfirio Gutkowski Triage View
5 months ago #158 Humberto Fisher Triage View
5 months ago #203 Raul Barton Triage View
5 months ago #155 Sterling Schoen Triage View
5 months ago #165 Roger Runte Triage View
5 months ago #213 Chong Casper Triage View
5 months ago #141 Malik Treutel Triage View
5 months ago #212 Blaine Sipes Triage View
5 months ago #143 Shenita Dooley Triage View
5 months ago #218 Zola Gibson Triage View
5 months ago #189 Porsha Lind Triage View
5 months ago #226 Wilhelmina Emmerich Triage View
5 months ago #187 Hisako Christiansen Triage View
5 months ago #219 Tracie Nader Triage View
5 months ago #181 Aleisha Rogahn Triage View

Process referral #144 for Dominick Smitham
Triage

Referral received at 5:41am on Fri 22nd Aug, 2025
Person with Dementia
MR Dominick Smitham 67yrs Other lives alone
05325 427252 / 032687586421 dominick_smitham@example.com 663 Deana Row, Apt. 186, Erickbury, QZ5 9VN
Preferred contact times: morning
Voluptas dolorum libero deleniti distinctio debitis.
DOB
11/8/1958
NHS
0011415576
GP
Ebert Hollow Practice
Ethnic group
Gypsy or Irish Traveller
Diagnosis
Referral made to memory clinic: No (Appointment date: 28/5/2025)
Downs Syndrome and Alzheimer's
Diagnosing clinician: Blanca Klein
12/8/2023
Sensory impairment: Officiis quia voluptas culpa dolore aspernatur quas excepturi.
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
MS Tiffiny (Ming) Pagac Niece
05849 052280 / 03712 190310 tiffiny_pagac@example.com 2834 Gulgowski Union, Suite 934, Erlineland, OF1 6MJ
Referrer
Zulma Pacocha Mollitia at eveniet dignissimos nesciunt doloremque in.
0771879842 / 089704534088 zulma_pacocha@example.com
Referral source
Hospital

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