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Referrals

External referral form
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Received Ref Name Stage
2 months ago #191 Leticia O'Connell Triage View
2 months ago #172 Kanesha Dare Triage View
2 months ago #225 Liza Bergnaum Triage View
2 months ago #207 Wilmer Jones Triage View
2 months ago #138 Johnny Schoen Triage View
2 months ago #177 Laurie Hartmann Triage View
2 months ago #145 Isaura Lebsack Triage View
2 months ago #205 Elizabeth Bartell Triage View
2 months ago #208 Marty Upton Triage View
2 months ago #161 Garland Metz Triage View
2 months ago #163 Anjanette Wuckert Triage View
2 months ago #135 Danilo Braun Triage View
2 months ago #215 Melba Quitzon Triage View
2 months ago #169 Johanna Bergstrom Triage View
2 months ago #173 Jaquelyn Hayes Triage View
2 months ago #216 Andre Tromp Triage View
2 months ago #224 Debby Jacobs Triage View
2 months ago #174 Shaunda Koss Triage View
2 months ago #179 Augustine Gutmann Triage View
2 months ago #166 Marisa Marks Triage View
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Process referral #177 for Laurie Hartmann
Triage

Referral received at 6:59am on Thu 28th Aug, 2025
Person with Dementia
MX Laurie Hartmann 92yrs Female lives alone
095892110846 / 0599775144 laurie_hartmann@example.com 4416 Marya Groves, Suite 894, East Kayleen, SY20 0CM
Preferred contact times: morning
Maxime quis ratione dolore cupiditate impedit dignissimos voluptatibus quam.
DOB
1/12/1932
NHS
0311542298
GP
Walsh Course Practice
Ethnic group
Prefer not to say
Diagnosis
Referral made to memory clinic: No (Appointment date: 11/12/2024)
Huntingdon's disease
Diagnosing clinician: Alejandro Grady
9/5/2025
Sensory impairment: Eius numquam excepturi repudiandae blanditiis velit pariatur.
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
DR Winfred Collier Husband
0539714253 / 03339 006675 winfred_collier@example.com 77274 Natalia Ridge, Suite 888, New Shawnna, KS54 3JE
Referrer
Bernardo Blick Laudantium consequatur rem perspiciatis quam id explicabo.
034166773013 / 029394245171 bernardo_blick@example.com
Referral source
AUKO I&A

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