Page 720 - 2015 2nd Half No Table

Age/Dob: ***
Ethnic origin: (Do coding)
Religion
Preferred language: English
Interpreter needed? No
Assessing AMHP
26 Jan 1981 (35 years old)
Dual heritage, white & black Caribbean
Not discussed during assessment
English: Yes
Sam Curtis
Services involved ease stats name, address.
Not applicable
Dr Kripalani. Consultant Psychiatrist,
Lucas House,
305 - 309 Fore Street.
Edmonton, London,
N9 OPD.
Tel: 020 8702 3100
Nightingale House Surgery,
1 Nightingale Road,
N9 8AJ
Tel: 020 88059997
Hospital Consultant GP
/CMHN / CMHT
Social worker/responsible local authority (Section 117)
Nearest relative
Goodie Adama, Care Coordinator and Community Mental Health Nurse,
Lucas House,
305 – 309
Fore Street,
Edmonton,
London, N9
OPD
Tel: 020 8702 3100
None
Name: Lorraine Cordell
Address: 23 Bryon Terrace, Edmonton Postcode N9 7DG
Age/Dob: Over 18
Mother
Informed? Yes:
Consulted? “Blank”
Objected? “Blank”
Reason not informed/consulted: N/a
Nearest relative notified of admission. No
Letter sent? No
Reason why not notified: “Blank”
Nearest relative informed of their legal rights? Yes
Names and contact information for significant others: “Blank”
Relationship to patient: Mother