| Visit Date: May 24, 2021 | ID Number: 153134 | ||
| Visit Count: | Children Served: Provider opted out of answer | 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 |
|||
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). Food insecurity, Financial strain |
|||
| Consultation Duration Start Time: 5:57 PM End Time: 6:29 PM Time Period: 30 mins |
|||
Goals |
|||
| Progress Made Towards Goal?: | |||
| Goal Attained? | |||
| Goal attained | |||
Notes for this Consultation
Provider requested food as she had knee replacement surgery which is healing slowly. Went to store and.picked up food from store to delivered to Provider at her home.
|
|||
|
 |
 |