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Visit Date: June 11, 2021 ID Number: 153200
Visit Count: Children Served: Provider opted out of answer Community Health Worker: Dahabo M

Consultation services Delivered

What type of Consultation was it? In-person consultation session

Healthy and Safe Environment Concerns

Child Development Concerns

Health Related Social Needs Concerns

Hand-washing – diapering – toileting. Answered: Yes

HealthCare Concerns

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: 3:03 PM
End Time: 3:15 PM
Time Period: 15 mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Progress made towards goal?

Notes for this Consultation

I delivered diapers and wipes I put them at front door.