Client Service Receipt Inventory (Csri) Page 5
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8CSRI CPA/10 years on
4.
SERVICE RECEIPT
4.1
What inpatient services has s/he used over the last 3 months?
(Note 1: please enter ‘0’ if service has not been used; Note 2: see manual for definitions)
Service
Name of
Number of
Total number of
facility
admissions
inpatient days)
Special hospital (e.g. Rampton)
Secure/semi-secure unit
Specialist assessment and/or
treatment facility
Acute psychiatric ward
Rehabilitation ward/facility
Long-stay ward
Emergency / crisis centre
General medical ward
Other (describe)
Other (describe)
Other (describe)
4.2
What outpatient services has s/he used over the last 3 months?
(Note 1: please enter ‘0’ if service has not been used; Note 2: see manual for definitions)
Service
Name of facility
Unit of
No. of units
measurement
received
Psychiatric outpatient visit
Appointment
Special unit outpatient visit
Appointment
Other hospital outpatient visit (incl. A&E)
Appointment
Day hospital (excl. regular day activities)
Days attended
Other (describe)
Other (describe)
Other (describe)
5
Version @ 24 November 1997
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