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Questionnaire for Kendall House Survivors and their Children/Grandchildren

14th Apr 2016 | in Reports and Downloads

We are working with a solicitor Madeline Seibert to build a database of all the children and grandchildren affected by birth defects and learning disabilities and… who were born to Kendall House Residents and those who were drugged in care. If you were drugged in care and went on to have children or grandchildren born with birth defects or learning disabilities from other UK institutions, we welcome your input too but please state clearly, the name of the unit you were drugged in. This information will be forwarded so it can be added to the database in the strictest confidence. If you wish to speak to us about it, please state that clearly in your email.

Questionnaire for Residents of Kendall House

Name:……………………………………………………………………………………………………

Address:……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Date of Birth:……………………………………………………………………………………………

Marital Status:…………………………………………………………………………………………..

Former Names (if any):……….………………………………………………………………………

Former Addresses:……………………………………………………………………………………. …………………………………………………………………………………………………………………………………………………………………………………………………………………………

Dates of residency at Kendall House:………………………………………………………………..
……………………………………………………………………………………………………………

Were you given drugs at Kendall House?        YES / NO

Do you have your Care Records?        YES / NO

Do you have any other relevant documentation or records? If so what?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

GP Name & Address:………………………………………………………………………………….
…………………………………………………………………………………………………………………………………………………………………………………………………………………………

Children’s full names and Dates of Birth: ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Grandchildren’s full names and Dates of Birth: ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Details of Birth Defect/Abnormalities complained about: ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

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