CHAT Tool - Offender Health Research Network

Tick No or Yes as appropriate for each question and include additional notes No Yes
SEXUAL ORIENTATION AND SEXUAL HEALTH
Have you decided on your sexuality
If Yes, indicate from the list which the young person identifies themselves as: heterosexual,
lesbian, gay, bisexual, transgender, questioning, intersex and asexual.
Have you ever had unprotected sex
Have you ever been tested or treated for a sexually transmitted disease
If Yes give details:
Would you like any sexual health screening e.g. Chlamydia or Gonorrhoea
Would you like any sexual health information
COMMUNICABLE DISEASES (consider if the young person has been sexually active/injected drugs)
Explain what HEPATITIS B is and the risks involved; explain what testing, vaccination and management of the
condition involve. Then ask:-
Have you ever been invited to have a test for Hepatitis B
If No, would you like to be tested
If No, state why
Have you ever been vaccinated against Hepatitis B
If No, would you like to be vaccinated
If No state why
Surname:
DOB:
Forenames:
NHS Number:
CHAT Tool Secure Estate (Version 3 - June 2013)
37 | P age