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Client Group
Client requires an advocate to help them
(Please give details on the client group above)
Please provide the following: - GP Name - Practice Address - Telephone Number
(please include anything that may affect potential home visits)
Please provide ALL Name, Position, Agency AND Contact
Has the client provided their consent to be contacted by the advocate?
(eg professionals, court appointed deputy, LPA, EPA, carers, family members, close friends etc)