CHAT Tool - Offender Health Research Network

INFORMATION FROM THE YOUNG PERSON
Tick No or Yes as appropriate for each question and include additional notes
Have you struggled with schoolwork
If Yes please provide details below: (clarify whether in primary, secondary school or both)
No
Yes
Did you have any additional support in lessons
If Yes please provide details below:
Has anyone told you that you have a learning disability or learning needs
If Yes please provide details below:
Do you struggle with reading or writing (show them a story in a magazine and discuss it
with them)
If Yes please provide details below:
Do you struggle telling the time (check using non digital clock)
If Yes please provide details below:
Surname:
DOB:
Forenames:
NHS Number:
CHAT Tool Secure Estate (Version 3 - June 2013)
92 | P age