The Sandbox Clinical Support

Clinician Support Form:
 

• provide a risk update, 

• request support from Care Coordination or the Senior Clinical Team, 

• notify Care Coordination of a Vitality session request.

These requests will come to the Care Coordination team via Zendesk and the response will be delivered to your email inbox. You are then able to respond with further questions, information or updates by replying to the email.

NOTE:  Please do not use the Clinical Incident Reporting form for  these requests.

Risk Notices:
To disclose risk/safeguarding and ask for clinical support, also to note safety plans and risk notices to be sent. Messages should be brief as most of the information should be on a Chart on Juvonno.

• What to include: your name, your email, your supervisor, the patient's chart number, if there is any action required, the patient's clinic (can be found on their Juvonno profile), safety plan and risk notice information, a very brief, anonymous description of the instance and any actions or information needed from the Care Coordination or the Senior Clinical teams.

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General Admin Requests:
For asking for actions or information from the Care Coordination team.
Note: No requests on this form should require clinical input, it is purely administrative.

• What to include: your name, your email, patient's chart number, patient's clinic (can be found on their Juvonno profile), and a brief description of the actions required or the information you need.

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Urgent Admin Requests:
For URGENT admin requests only, this is only for appointments that are on the same day as the requests. Please only use this section of the form if the request is urgent, for example: sudden illness or technical issues that means sessions need to be cancelled and YPs notified as soon as possible.

• What to include: your name, your email, patient's chart number, patient's clinic (can be found on their Juvonno profile), and a brief description of the actions required or the information you need.

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Clinical Support/Supervision Tasks (NO RISK):
For specific clinical queries that do not require administrative input, e.g. service suitability. This section of the form should NOT be used for risk or safeguarding queries (use the risk section instead for those).

• What to include: your name, your email, your supervisor, patient's chart number, patient's clinic (can be found on their Juvonno profile), and a brief description of the actions required or the information you need.

• Do not include: Any patient data or identifiable information

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Extra Session Requests (Vitality only):
For notifying Care Coordination that you have completed a session request form on Juvonno, and need it to be sent to Vitality.

• What to include: your name, your email, patient's chart number, number of sessions requested.

Please do not book or complete sessions beyond the amount that has been approved by Vitality.