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Referrals

External referral form
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Received Ref Name Stage
21 days ago #91 Donald Glover Triage View
21 days ago #29 Jeffery Kuvalis Triage View
21 days ago #55 Willian Kilback Triage View
21 days ago #40 Susannah Kovacek Triage View
22 days ago #13 Phebe Kris Triage View
22 days ago #50 Raymond Christiansen Triage View
22 days ago #2 Jimmie Oberbrunner Triage View
22 days ago #47 Douglass Dietrich Triage View
22 days ago #56 Joi Jast Triage View
22 days ago #49 Brad Towne Triage View
22 days ago #23 Giovanni Hintz Triage View
22 days ago #99 Benjamin Rau Triage View
22 days ago #4 Dylan Ledner Triage View
22 days ago #18 Glenn Brekke Triage View
22 days ago #60 Myron Aufderhar Triage View
22 days ago #69 Rodrick Friesen Triage View
23 days ago #71 Ashleigh Brown Triage View
23 days ago #73 Oren Rowe Triage View
23 days ago #37 Colton Lynch Triage View
23 days ago #51 Emile Schaden Triage View
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Process referral #40 for Susannah Kovacek
Triage

Referral received at 10:05pm on Tue 20th May, 2025
Person with Dementia
PROFESSOR Susannah Kovacek 72yrs Female lives alone
0403855502 / 06827 475457 susannah_kovacek@example.com 1468 Jakubowski Isle, Apt. 544, Felisabury, GF18 8EO
Preferred contact times: afternoon
Cumque voluptas beatae cupiditate sint ab ipsam.
DOB
12/3/1953
NHS
6745517337
GP
Kemmer Passage Practice
Ethnic group
Any other White background
Diagnosis
Referral made to memory clinic: Yes (Appointment date: 4/10/2024)
Parkinson's disease dementia (PDD)
Diagnosing clinician: Maudie Wolf
3/6/2023
Sensory impairment: Temporibus neque voluptate incidunt rerum.
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 Kathie Oga Stepdaughter
09578 667146 / 0524109508 kathie_oga@example.com 922 Monahan Roads, Suite 353, West Lula, HM36 6QE
Referrer
Nicky Rosenbaum Corporis laborum ut officia odio commodi earum.
08246 893613 / 0211835915 nicky_rosenbaum@example.com
Referral source
AUKO GG

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