| Visit Date: May 11, 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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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 | |||
| Did you make a Community Resource-Referral. Answered: Yes | |||
| Resource-Referral Type(s). Interpersonal safety, Financial strain, Family and community support |
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| Consultation Duration Start Time: 4:24 PM End Time: 4:41 PM 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 being abused by her father. The abusive litigation lawyer send the mother paperwork to fill out. Consultation continued to help navigate and support the mother to fill out and collect requested documents and reports.
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