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Received Ref Name Stage
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Process referral #89 for Blanca Gutkowski
Triage

Referral received at 10:05pm on Sat 10th May, 2025
Person with Dementia
MS Blanca Gutkowski 80yrs Female lives alone
084938050607 / 02059 099324 blanca_gutkowski@example.com 8339 Tabatha Locks, Apt. 658, Janisburgh, ZS4 4UO
Preferred contact times: any
A et sit atque natus optio.
DOB
15/4/1945
NHS
8830701084
GP
Schoen Walk Practice
Ethnic group
Arab
Diagnosis
Referral made to memory clinic: Yes (Appointment date: 24/10/2024)
Alzheimer's disease
Diagnosing clinician: Monty Mosciski
24/1/2025
Sensory impairment: Libero deserunt architecto quis quidem reprehenderit.
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 Harland Johnson Grandson
0367304668 / 08445 278517 harland_johnson@example.com 22703 Nikolaus Hill, Apt. 760, Billburgh, FJ4 0XH
Referrer
Dalila Eichmann Explicabo architecto minima quas quia.
025645560842 / 057762726857 dalila_eichmann@example.com
Referral source
Self Referral

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