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Visit Date: May 3, 2021 ID Number: 153159
Visit Count: Children Served: 5 Community Health Worker: SIC Other Staff

Consultation services Delivered

What type of Consultation was it? Collaborative Collateral Contact
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

How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes
Coping with stressful situations. Answered: Yes
Did you make a Community Resource-Referral. Answered: Yes
Resource-Referral Type(s).
Family and community support, Covid 19 Related Information
Consultation Duration

Start Time: 4:18 PM
End Time: 6:07 PM
Time Period: 45 mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained

Notes for this Consultation

Collaborative consultation with nurse to support on of the provider’s family who has been sick at home with covid-19 for 19 days and said she is experiencing shortness of breath. Recommend to family to take the grandmother to the emergency room. Done.