Guest Quarterly Review Form – Leeds Asylum Seekers' Support Network

Client’s Name:

First Name

Last Name

Person Completing this Update:

First Name

Last Name

Update on Asylum Application

Managing risks and staying safe

It is really important to us that you are safe when you are staying with LASSN. It is also important you know what information is shared about you by your referral agency and LASSN.

We will keep all of your information confidential, and will only discuss this with people who need to know – which is usually the people providing you with casework. We use this information to make sure you are housed safely, in the best possible place for you. We do not need to know why you have fled from your homeland. We ask all our guests the same questions. Please do not be offended if they do not apply to you.

Please tell us if you have been involved in any violent incidents in the last 3 months.

Please tell us about any problems you’ve had with the Police or with criminal justice services (including convictions) in the last 3 months

Please tell us about any difficulties you may have with your mental health in the last 3 months?

Please tell us about your drugs or alcohol use (amount, frequency) over the last 3 months

Sometimes people can be hurt or exploited by other people. Please tell us about any situations in the last 3 months where you felt really unsafe (might include domestic abuse, and/trafficking)

Please describe any physical health needs you’ve not already mentioned

Please tell, us about anything else you think is relevant, or that has changed in the last 3 months

Declaration

Guest

I confirm that the information I have provided is complete and true to the best of my knowledge

Caseworker

I confirm that the information I have provided is complete and true to the best of my knowledge