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Client Risk Assessment
Client Risk Assessment
Client Risk Assessment
Client Risk Assessment
Client Name
*
Client Name
First
First
Last
Last
Date of Birth
*
Sources of Information used for completion (e.g. client interview, review of notes, carer, support worker, etc.)
*
Suicide / Self-Harm
Static Factors
Previous Attempt
*
Yes
No
Previous Self-harm
*
Yes
No
Exposure to Suicide
*
Yes
No
Stressful life events
*
Yes
No
Suicide / Self-Harm
Dynamic Factors
Suicidal Thoughts
*
Yes
No
Plan
*
Yes
No
Loss of Hope
*
Yes
No
Lack of Social Support
*
Yes
No
Risk Rating
*
Low
Medium
High
Summary of Risks
*
Protective Factors
*
Violence / Aggression
Static Factors
Property Damage
*
Yes
No
Violent/Agressive Behaviour
*
Yes
No
Sexually Inappropriate Behaviour
*
Yes
No
Domestic/Family Violence
*
Yes
No
Problematic Substance Misuse
*
Yes
No
Criminal Charges
*
Yes
No
Violence / Aggression
Dynamic Factors
Anger
*
Yes
No
Impulsivity
*
Yes
No
Problematic Substance Use
*
Yes
No
Violent Ideation
*
Yes
No
Carries Weapons
*
Yes
No
Other Problematic Behaviour
*
Yes
No
Risk Rating
*
Low
Medium
High
Summary of Risks
*
Vulnerability
Static Factors
History of trauma or abuse
*
Yes
No
History of domestic/family violence
*
Yes
No
Cognitive impairment/disability
*
Yes
No
Lack of family support
*
Yes
No
Vulnerability
Dynamic Factors
Impaired Decision Making
*
Yes
No
Sexually disinhibited
*
Yes
No
Self-neglect
*
Yes
No
Impaired interpersonal victimisation
*
Yes
No
At risk of exploitation
*
Yes
No
Risk of homelessness
*
Yes
No
Risk Rating
*
Low
Medium
High
Summary of Risks
*
Absconding
Static Factors
History of absconding
*
Yes
No
Absconding
Dynamic Factors
Poor Road Skills
*
Yes
No
Risk Rating
*
Low
Medium
High
Summary of Risks
*
Medical Conditions and Personal Care
Static Factors
Seizures
*
Yes
No
Tripping and Falling
*
Yes
No
Dysphagia (difficulty swallowing)
*
Yes
No
Choking
*
Yes
No
Allergies
*
Yes
No
Respiratory Conditions
*
Yes
No
Diabetes
*
Yes
No
Medical Conditions and Personal Care
Dynamic Factors
Bladder Management
*
Yes
No
Bowel Management
*
Yes
No
Mobility
*
Yes
No
Obesity
*
Yes
No
Medication
*
Yes
No
Feeding
*
Yes
No
Showering/Bathing
*
Yes
No
Dental Hygiene
*
Yes
No
Risk Rating
*
Low
Medium
High
Summary of Risks
*
Does the client have any sensory preferences for when attending appointments (e.g. lighting, noise, etc.)
*
Does the client need any assistance when attending and engaging in appointments?
*
Is the client able to independently find their way home after the session or do they require support?
*
Risk Formulation and Risk Management Support Plan (What current supports are in place or are being developed to manage identified risk)
*
Risk Assessment Completed by
*
Designation
*
Date
*
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