| Visit Date: May 2, 2021 | ID Number: 153102 | ||
| Visit Count: | Children Served: 1 | Community Health Worker: SIC Other Staff | |
Consultation services Delivered |
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| 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 |
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Child Development Concerns |
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| How my relationship with the children can help them feel secure about themselves. Answered: Yes | |||
Health Related Social Needs Concerns |
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HealthCare Concerns |
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| How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes | |||
| Coping with stressful situations. Answered: Yes | |||
| Child Caregiver relationship. Answered: Yes | |||
| Caregiver of Child relationship. Answered: Yes | |||
| Resource-Referral Type(s). Interpersonal safety |
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| Consultation Duration Start Time: 10:00 AM End Time: 10:12 AM Time Period: 15 mins |
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Goals |
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| Progress Made Towards Goal?: | |||
| Goal Attained? | |||
| Goal attained | |||
Notes for this Consultation
Provider stressed about his grandchild and her mother being harrassed and harmed by the child’s father. Support child mother in preparation and sending of second request for health information of doctors who he claims he took his grandchild took yesterday and any other time. The child’s father responded and continues to refused .
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