| Visit Date: May 17, 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 |
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| Consultation Duration Start Time: 8:59 AM End Time: 10:11 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 continues. While supporting them yesterday. His car was broken into and his work instruments was stolen. If not for the need to provide mood .emotional and child engagement protective support for his grandchild and mother his car would not have been parked in the area where it was broken into. Consultation contact his car insurance company asking if his policy covers his stolen work tools and materials.
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