Enquiries

Upload EMIS referral MT Enquiry form

Select a tab

Draft Inbox Accepted Duplicate Rejected

Name	Status	Submitted at
Lora Kassulke	Rejected	6th Mar	View enquiry
Versie Doyle	Rejected	26th Feb	View enquiry
Dwa Keebler	Rejected	18th Dec 2024	View enquiry
Kel Bode	Rejected	9th Sep 2024	View enquiry

View enquiry

Enquiry for Dwa Keebler #4372 GO Active Get Healthy - Diabetes

Self-referral

Rejected

Received at 4:01am on Wed 18th Dec, 2024

Rejection notes: Minus alias dolor earum ab hic suscipit quaerat mollitia.

Contact details

Name: Dwana 'Dwa' Keebler

Email: dwana_keebler@example.com

Phone: 030 1753270 / 0874 3404986

009 Corkery Bridge, Apt. 406, Suite 118, Port Rikki, OX26 6LG

NHS Number: 9434765919

GP Practice: Woodlands Surgery

Demographics

Age: 98 yrs (26/10/1926)

Gender: Female

Ethnic group: Bangladeshi

Health

Physical or mental health condition: Yes (Coronary Heart Disease, Hypertension (high blood pressure), Hypothyroidism, Asthma, Respiratory Disease (e.g. COPD or emphysema), Other Mental Health Condition, Neurological Disorder, Falls, Obesity)

Disability: Yes (Learning or concentrating or remembering, Mental health, Stamina or breathing difficulty, Other impairment)

Pregnancy

Pregnant: No

Postnatal: No

Person to contact

Name: Belinda Powlowski

Email: belinda_powlowski@example.com

Phone: 047 6184042

Relationship: Partner

Best time to contact: Anytime except the weekend

Other details

Enquiry reason:

Other relevant information: Nisi cupiditate dignissimos sit quos similique fuga asperiores consequuntur.

On shielded list? Yes

Heard about from: Specialist nurse e.g. diabetic nurse, respiratory nurse

Interpreter required: Perferendis quo at labore sed.

Communication difficulties: Repudiandae repellendus placeat consequatur porro iste totam.

Created by Oxford Code Lab