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Referrals

External referral form
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Received Ref Name Stage
2 months ago #219 Tracie Nader Triage View
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3 months ago #175 Lemuel Strosin Triage View
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3 months ago #193 Lamont Kunze Triage View
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Process referral #164 for Cedric (Kenneth) Schmeler
Triage

Referral received at 6:10pm on Mon 18th Aug, 2025
Person with Dementia
DR Cedric (Kenneth) Schmeler 66yrs Male
096476947990 / 0395413480 cedric_schmeler@example.com 3478 Altenwerth Camp, Suite 058, South Theronfurt, MZ03 9ZP
Preferred contact times: morning
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DOB
17/6/1959
NHS
8700390143
GP
Walsh Course Practice
Ethnic group
Any other Mixed or Multiple ethnic background
Diagnosis
Referral made to memory clinic: Yes (Appointment date: 6/6/2025)
Dementia (origin non-specific)
Diagnosing clinician: Etta Feest
6/2/2025
Sensory impairment: Deleniti ducimus porro neque nobis doloremque perspiciatis amet assumenda.
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
MX Neomi (Bonita) Metz Stepdaughter
0917404606 / 0896552798 neomi_metz@example.com 32163 Shalanda Pine, Apt. 449, North Onitabury, IK3 7WR
Referrer
Cassi Lang Quaerat officiis ratione mollitia odit nostrum.
04236 847828 / 0435020473 cassi_lang@example.com
Referral source
Other NHS service

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