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Referrals

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Received Ref Name Stage
2 months ago #29 Jeffery Kuvalis Triage View
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2 months ago #31 Jerry Jakubowski Triage View
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Process referral #41 for Shasta Pouros
Triage

Referral received at 9:18am on Fri 9th May, 2025
Person with Dementia
MRS Shasta Pouros 77yrs Female
08170 291111 / 0433808418 shasta_pouros@example.com 21060 Kreiger Rapids, Suite 888, Krisberg, DX06 9TI
Preferred contact times: morning
Quae a harum molestias quidem amet consequatur.
DOB
21/10/1947
NHS
4146955793
GP
Lara Greens Practice
Ethnic group
Any other ethnic group
Diagnosis
Referral made to memory clinic: Yes (Appointment date: 10/10/2024)
Vascular dementia
Diagnosing clinician: Derrick Maggio
29/3/2023
Sensory impairment: Adipisci voluptates iste suscipit quia temporibus sed soluta.
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 Dane (Ezra) Frami Civil partner
0878732197 / 0439911973 dane_frami@example.com 735 Baumbach Course, Suite 473, South Kurtis, KS7 1BQ
Referrer
Tawna Koelpin Quibusdam quaerat deserunt itaque tempore amet voluptate maiores hic.
04122 709174 / 0992269633 tawna_koelpin@example.com
Referral source
Family or Friend

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