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Visit Date: April 14, 2021 ID Number: 153116
Visit Count: Children Served: Provider opted out of answer Community Health Worker: SIC Other Staff

Consultation services Delivered

What type of Consultation was it? Phone or virtual consultation session

Healthy and Safe Environment Concerns

Child Development Concerns

Childcare Play and Learn and / or outdoor time. Answered: Yes

Health Related Social Needs Concerns

HealthCare Concerns

Coping with stressful situations. Answered: Yes
Resource-Referral Type(s).
Family and community support
Consultation Duration

Start Time: 5:06 PM
End Time: 6:14 PM
Time Period: 60+mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Progress made towards goal?

Notes for this Consultation

Provider stressed out trying to get a copy of the child’s birth certificate from Montana. Consultation assisted by downloading and emailing the provider pdf copies of MO certificate application with instructions to get notarized by both herself as fictive kin and the child’s mother. Follow up usps verification mailing .