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Visit Date: April 22, 2021 ID Number: 153102
Visit Count: Children Served: Provider opted out of answer Community Health Worker: SIC Other Staff

Consultation services Delivered

What type of Consultation was it? Indirect Consultation
Get information on how to help me cover my basic needs (food – clothing – housing – medical attention) Answered: Yes

Healthy and Safe Environment Concerns

How to prevent the spread of illness: Answered: Yes

Child Development Concerns

Health Related Social Needs Concerns

HealthCare Concerns

Taking care of yourself (Whole Person). Answered: Yes
How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes
Coping with stressful situations. Answered: Yes
Caregiver of Child relationship. Answered: Yes
Resource-Referral Type(s).
Food insecurity, Financial strain, Covid 19 Related Information
Consultation Duration

Start Time: 11:16 AM
End Time: 12:18 PM
Time Period: 60+mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained

Notes for this Consultation

Provider re-engage with grandchildren mother. Completed provider daughter’s covid19 social risk profile snapshot and trained her in how to do provider’s social risk profile snapshot.