| Visit Date: June 3, 2021 | ID Number: 153300 | ||
| Visit Count: | Children Served: Provider opted out of answer | Community Health Worker: Dahabo M | |
Consultation services Delivered |
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| What type of Consultation was it? In-person consultation session | |||
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 | |||
| Did you make a Community Resource-Referral. Answered: Yes | |||
| Consultation Duration Start Time: 9:30 PM End Time: 9:45 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 called and said I am coming to your house, before My son’s appointment there is a form to fill out, you can help me.
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