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QUEENSLAND CORRECTIVE SERVICES
ADMINISTRATIVE FORM – WOODFORD CORRECTIONAL CENTRE – ADVERSE
OUTCOMES CHECKLIST
Availability: Public
Implement Date: 30 December 2008
Authority – Corrective Services Act 2006 s201 – 203, 205, 263 – 266
Date Returned:
Prisoner Name:
Destination Returned
from:
Time Returned:
IOMS Number:
Accommodation Area:
1)
Were you refused bail today?
Yes
[ ]
No
[ ]
2)
Are you distressed by this outcome?
Yes
[ ]
No
[ ]
3)
Were you found guilty on your charges today?
Yes
[ ]
No
[ ]
4)
Are you distressed by this outcome?
Yes
[ ]
No
[ ]
5)
Were you sentenced today?
Yes
[ ]
No
[ ]
6)
Are you distressed by this outcome?
Yes
[ ]
No
[ ]
7)
Are you thinking of harming yourself?
Yes
[ ]
No
[ ]
8)
Are you thinking of committing suicide?
Yes
[ ]
No
[ ]
Prisoner Signature: …………………………………………………. Date:……/……/……
All prisoners returning from an escort MUST BE ASSESSED by a Psychologist or Registered
Nurse prior to their return to their unit. Please contact the Psychologist / Registered Nurse to
arrange for this assessment.
NB: If the prisoner does not meet the criteria for psychological assessment, but you believe there
are indicators of self-harm risk, refer the matter to the Psychologist / Registered Nurse as per QCS
procedure At- Risk Management (Self Harm/Suicide).
Action:
[
[
[
[
]
]
]
]
No action necessary
Psychologist / Registered Nurse contacted at …………am/pm
Duty Supervisor / Night Supervisor notified at ……..am/pm
Prisoner placed in Safety Unit at ………am/pm
Officers Name: …………………………
Officer’s Signature: …………………….
Officer’s Position: ………………………
Woodford - Adverse Outcomes Checklist
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