| Visit Date: May 6, 2021 | ID Number: 153102 | ||
| Visit Count: | Children Served: Provider opted out of answer | 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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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, Family and community support |
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| Consultation Duration Start Time: 11:01 AM End Time: 11:16 AM Time Period: 15 mins |
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Goals |
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| Progress Made Towards Goal?: | |||
| Goal Attained? | |||
| Progress made towards goal? | |||
Notes for this Consultation
Provider stressed about his grandchild and her mother continues. The cps home visit over with plan to follow-up when results from child medical exam come in. Ensured mother will get it.
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