| Visit Date: June 10, 2021 | ID Number: 153113 | ||
| 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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| Taking care of yourself (Whole Person). Answered: Yes | |||
| 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). Family and community support |
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| Consultation Duration Start Time: 5:31 PM End Time: 7:16 AM Time Period: 60+mins |
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Goals |
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| Progress Made Towards Goal?: | |||
| Goal Attained? | |||
| Goal attained | |||
Notes for this Consultation
Provider stressed while enduring Covid-19 having to pay for legal services to petition the court to give her custody of her great grandson because his mom is suffering from a disability that prevent her from safely parenting and caring from him unsupervised. Consultation and referral to legal services that agreed to represent her.
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