CHAT Tool - Offender Health Research Network

Tick No or Yes as appropriate for each question and include additional notes No Yes
SWEATS – have you recently been feeling sweaty at night or any other time
PAIN – have you recently had any pain anywhere
MAJOR ILLNESSES – have you ever been seriously ill – What When Outcome
Give details:
HOSPITAL – have you ever been in hospital – Where Why How long Name of
consultant
Give details:
Surname:
DOB:
Forenames:
NHS Number:
CHAT Tool Secure Estate (Version 3 - June 2013)
28 | P age