Antidote Keyworking Submission

Antidote Keyworking Session Attendance Submission

First Name (or Client Reference if known):

Surname (or Client Initials if Client Ref is known):

Date of Session (dd/mm/yy):

Location:--None--LF Caledonian RoadWardour StreetCDCCodecliniQPhoneEmail/letterOutreachOtherOnline

Attendance:--None--AttendedDid not attendCancelled - clientCancelled - LFNot applicable

Session notes:

HIV Prevention England Stats

HIV Advice & Information given?:

Client closure information (complete only at last session)

Closure Scale:

Please indicate where the client placed themselves on the scale (0 poor to 20 good)
A: Control over Drug/Alcohol Use
B: Sense of Control around Managing Sexual Risk

Closure Questions:

C: Do you feel your work with Antidote has improved your knowledge/use of drugs/alcohol?
D: Do you feel your work with Antidote will serve to improve your health and wellbeing?
E: If you are HIV+ or HEPC+, has your work with Antidote helped with you adherence to your meds?
F: How important was it for you to be able to access an LGBT specific drug and alcohol service (0 not at all important to 10 very important):

Onward referral (complete only at last session)

Referral Category:--None--Discharged - no referralAntidoteLondon Friend counsellingOther LGBT counsellingOther general counsellingOther LGBT serviceSexual health clinicHIV support/managementOther drug serviceOther alcohol serviceHousingMoney/debtStatutory mental health

Referral Detail:--None--PACEELOPTHTPink TherapyStonewallStonewall Housing56 Dean StreetSwishMortimer MarketKobler ClinicGMFACDCLocal serviceLocal authorityOther

Referral Comments: