CHAT Tool - Offender Health Research Network

CHAT ASSESSMENT OF CAPACITY AND CONSENT FORM
Surname:
Forenames:
NHS Number: Admission Number: DOB:
Assessment of Capacity
Young people aged 16-17 are presumed in law to have capacity to give consent for themselves.
Young people under 16 can give consent, but only if they are able to fully understand what is proposed.
An assessment of capacity must be undertaken when a young person is under the age of 16 and does not want
to involve parents/guardian.
Young people aged 16-17 with learning difficulties or mental health issues must also be assessed.
If a young person has been assessed as having capacity to consent, capacity should be re-assessed each time
an assessment is completed.
Reception Screen No Yes
Is the young person currently impaired e.g. intoxication/injury/disability
Does the young person have capacity to give consent for assessment
Does consent need to be obtained by parent/legal guardian/person holding parental responsibility
Name of professional completing capacity assessment:
Signature:
Date:
Physical Health Assessment No Yes
Is the young person currently impaired e.g. intoxication/injury/disability
Does the young person have capacity to give consent for assessment
Name of professional completing capacity assessment:
Signature:
Date:
Substance Misuse Assessment No Yes
Is the young person currently impaired e.g. intoxication/injury/disability
Does the young person have capacity to give consent for assessment
Name of professional completing capacity assessment:
Signature:
Date:
Surname:
DOB:
Forenames:
NHS Number:
CHAT Tool Secure Estate (Version 3 - June 2013)
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