Hi Sam
I don't think you should worry about it. It's a review form so you don't have to give as much detail. Unless your mother's condition has improved then you are unlikely to contradict anything that you have said in the past. I'm sure knowing roughly will be enough.
If you can't copy the report and you have a mobile - take photographs of the form so you have a copy.
BIS
Nothing on this board constitutes legal advice - always consult a professional about specific problems