Settings Community Hospital GP Practice Emergency Dept Perioperative Clinics Laboratories End of life care (hospital) End of life care (community) Occupational Health Hospital ward Outpatients Intensive Care Other please specify: – Physical Conditions/ Diseases Cancer - Please specify: Bladder; Bone; Breast; Female Genital; Gastrointestinal; Haematological; Head and Neck; Leukaemia; Lung; Lymphoma; Male Genital; Multiple Myeloma ; Nervous System; Pancreatic; Renal; Skin Communicable disease (Sepsis, Congenital & Hereditary Cardiovascular/ heart disease HIV, HCAI etc.) Digestive system (biliary including IBD, IBS, Coeliac) tract, intestinal, liver, oesophageal, pancreatic, stomach Endocrine diseases (including Ear, nose and throat, hearing Eye /Vision disorders Diabetes) disorders Haemic & Lymphatic Kidney Diseases / Urinary Tract Immune System Diseases Musculo-skeletal/Joint Diseases Nervous System Disorders (Epilepsy, Men’s health (Arthritis etc.) MS etc) Nutritional & Metabolic Pregnancy & Child Birth Pain Respiratory Tract (COPD, Sexual Health Skin & Connective Tissue Asthma etc) Stroke Hypertension Health Wounds & Injuries Women’s Additional Detail or Other: Mental Disorders/ Diseases Bipolar Disorders Anxiety Disorders Alcohol/ Substance Misuse Dementia Depressive Disorders Eating Disorders Personality Disorders Learning Disorders Mood Disorders Schizophrenia/ Psychotic Self-harm Sleep Disorders Disorders Additional Detail or Other :
Settings GP Practice Community Clinics Emergency Dept Perioperative Hospital Laboratories End of life care (hospital) End of life care (community) Occupational Health Hospital ward Outpatients Intensive Care Other – please specify: Physical Conditions/ Diseases Cancer - Please specify: Bladder; Bone; Breast; Female Genital; Gastrointestinal; Haematological; Head and Neck; Leukaemia; Lung; Lymphoma; Male Genital; Multiple Myeloma ; Nervous System; Pancreatic; Renal; Skin Cardiovascular/ heart disease Communicable disease (Sepsis, HIV, HCAI etc.) Congenital & Hereditary Digestive system (biliary tract, intestinal, liver, oesophageal, pancreatic, stomach including IBD, IBS, Coeliac) Ear, nose and throat, hearing disorders Endocrine diseases (including Diabetes) Eye /Vision disorders Haemic & Lymphatic Kidney Diseases / Urinary Tract Immune System Diseases Men’s health Musculo-skeletal/Joint Diseases (Arthritis etc.) Nervous System Disorders (Epilepsy, MS etc) Nutritional & Metabolic Pain Pregnancy & Child Birth Respiratory Tract (COPD, Asthma etc) Sexual Health Skin & Connective Tissue Stroke Hypertension Women’s Health Wounds & Injuries Additional Detail or Other: Mental Disorders/ Diseases Anxiety Disorders Alcohol/ Substance Misuse Bipolar Disorders Dementia Depressive Disorders Eating Disorders Learning Disorders Mood Disorders Personality Disorders Schizophrenia/ Psychotic Disorders Self-harm Sleep Disorders Additional Detail or Other :