Oxford Refugee Health Initiative Question Title * 1. Your initials OK Question Title * 2. Family ID number (your initial + family number) OK Question Title * 3. Date of contact/activity Date / Time Date OK Question Title * 4. Time spent < 15 mins 15-30 mins 30-60mins 1-2 hours 2-5 hours >5 hours OK Question Title * 5. Location family home GP practice Hospital community Other (please specify) OK Question Title * 6. Health activity conducted (you can tick more than one box) Explanation of health system Accompany to a health appointment Accompany to another health related activity Going through health records Supervision received Other action or further description of activity (please specify) OK Question Title * 7. Other activity conducted (e.g. social care needs etc..) OK Question Title * 8. Are there any safeguarding concerns that this work has raised? Yes/not sure- will discuss No OK Question Title * 9. Will you do any of the following after this contact: discuss at supervision inform GP of new information Other (please specify) OK Question Title * 10. Any other comments OK DONE