| Visit Date: May 22, 2021 | ID Number: 153134 | ||
| 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 | |||
| Did you make a Community Resource-Referral. Answered: Yes | |||
| Resource-Referral Type(s). Food insecurity, Financial strain |
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| Consultation Duration Start Time: 8:06 PM End Time: 8:22 PM 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
Wellness check, provider stressed about her medical recovery from knee replacement surgery. Slow healing. Report health stable. Need food. Plan to pick up and deliver culture appropriate food.
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