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Received Ref Name Stage
about 1 month ago #12 Alla DuBuque Triage View
about 1 month ago #21 Ivelisse Sipes Triage View
about 1 month ago #57 Michale Tremblay Triage View
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about 1 month ago #100 Milda Hills Triage View
about 1 month ago #22 Carter Bins Triage View
about 1 month ago #66 Santo Pacocha Triage View
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about 1 month ago #86 Abigail Hettinger Triage View

Process referral #29 for Jeffery Kuvalis
Triage

Referral received at 1:30am on Wed 21st May, 2025
Person with Dementia
DR Jeffery Kuvalis 95yrs Male
048948909740 / 032925269978 jeffery_kuvalis@example.com 10837 Beahan Points, Apt. 910, Sherrilbury, PF50 2LF
Preferred contact times: any
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DOB
7/5/1930
NHS
1040086632
GP
Oga Pike Practice
Ethnic group
White and Black African
Diagnosis
Referral made to memory clinic: No (Appointment date: 15/3/2025)
Other mixed dementia
Diagnosing clinician: Annie Beatty
10/9/2022
Sensory impairment: Inventore sunt sed sit voluptate vero.
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
MR Max Hessel Grandson
083237541788 / 08263 222563 max_hessel@example.com 5323 Jonie Manor, Apt. 103, Klockomouth, UB5 1CL
Referrer
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0313704550 / 09530 797813 zoila_conroy@example.com
Referral source
CMHT

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