Page 1424 - 6. 2016 Diary 1st half New 26-05-21 No Table

Consultant:
GP:
CMTN/CMHT Social worker responsible local authority (Section 117)
Services involved (Please state name, address, phone no.}
Nearest relative
Name: Mrs Lorraine Cordell
Address: 23 Byron Terrace
Edmonton
London
Postcode: N9 7DG
Phone no: 02082457454
Age/Dob: /
Relationship to patient Mother
Informed? Yes
Consulted? “Blank”
Objected? “Blank”
Reason not informed/consulted
Nearest relative notified of admission. Yes
Letter sent?
Reason why not notified: “Blank Line”
Nearest relative informed of their legal rights? Yes
Names and contact information for significant others: “Signed”
Patient’s rights
Was the patient made aware of his/her legal status and rights under the 1983 Mental Health
Act at time of interview?
If ‘No’, please state date when he/she was made aware of above.
Assessment details
Date of
initial Date of
referral: 15/08/2016 assessment 18/08/2016
Changed Changed
above with above with
pen pen
Place of Wood Green Police Station
assessment:
Medical recommendations from:
Dr. Albazaz Date: 15/08/2016
Dr. Amin Date: 15/08/2016
Please select if Sec. 12 doctor or GP
Legal status at time of assessment
Yes inf. “Blank” Sec. 135
“Blank” Sec 2 “Blank” Sec. 136
Detained by
“Blank” Sec.3 “Blank”
Police, not
“Blank” Sec.4 “Blank” under Sec. 136
“Blank” Sec. 5(2) “Blank” CTO
“Blank” Sec.7 “Blank” Other
Legal status at end of assessment
Any delays in admission process? Wait for Bed