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Visit Date: May 1, 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

How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes
Coping with stressful situations. Answered: Yes
Medication Management Adult (Non Clinical). Answered: Yes
Child Caregiver relationship. Answered: Yes
Caregiver of Child relationship. Answered: Yes
Consultation Duration

Start Time: 6:54 AM
End Time: 11:31 AM
Time Period: 60+mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained

Notes for this Consultation

Provider stressed about his grandchildren mother. Sent her reading material regarding children destroying their dolls and remembering to contact her pharmacy to see if her medication was ready. She followed through and medication was ready and she said she plan to pickup today.