Author: Dave

WHO IS IMPORTANT TO ME?
.................................................
When I am sad they help me by:
They can be contacted on the following number/s:
..............................................
..............................................

ANYTHING ELSE I WANT TO SAY

People who access our services are welcome to talk to the Team Manager if they are experiencing any problems with their care .

Feedback
We welcome any suggestions you have, please send your comments, concerns, complaints and compliments to: PALS, complaints and incidents team, Cheshire and Wirral Partnership NHS Foundation Trust, Redesmere, Countess of Chester Health Park, Liverpool Road, Chester, CH2 1BQ
The information in the leaflet was valid at the date of production July 2015 and is due for review in July 2017
Leaflet code: D-OSCP-15-664

(NAME)’s Care Plan
16+

What I will find in my care plan:
‘A bit about me’
My treatment options
Who is important to me
Anything else I want to say

Designed and created by West Cheshire 0-16 CAMHS PPI Group 2015

A BIT ABOUT ME...
NAME:
DATE OF BIRTH:
HEALTH CONDITION:
CONSENT:
I would/would not like my parents / carers to be informed.
(I am entitled to this choice unless you believe that I am a significant risk to myself)
HOW BEST TO SUPPORT ME
I would appreciate this care if I were to harm myself:
Please try to understand that I may be upset and distressed.
I would appreciate if you would not judge me or patronise me.

TREATMENT DOs and DON’Ts :
Things that you may need to know about me which I do not wish to discuss.
Please do not ask me the following questions as they would make me feel uncomfortable or worse.

MY TREATMENT
Gender and Age of person giving my treatment: If possible, I would prefer:
MALE/FEMALE
YOUNGER/OLDER
however I know you may not be able to accommodate this.
Any allergies I have to anything that may affect my treatment:
What my usual pain relief is: