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Visit Date: April 29, 2021 ID Number: 153102
Visit Count: Children Served: 1 Community Health Worker: SIC Other Staff

Consultation services Delivered

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

Healthy and Safe Environment Concerns

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).
Interpersonal safety, Family and community support, Disabilities
Consultation Duration

Start Time: 9:03 PM
End Time: 11:27 PM
Time Period: 60+mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained

Notes for this Consultation

Provider stressed that his grandchild mother has to communicate with thr child’s abusive father about the child needing medical procedures to remove popcorn kernel from her ear canal. Consultation support her writing note informing him of the who, when,, where, how and what happened in a way to minimize his abuse of her. Completed.