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Visit Date: July 21, 2021 ID Number: 153302
Visit Count: Children Served: Provider opted out of answer Community Health Worker: Dahabo M

Consultation services Delivered

What type of Consultation was it? Phone or virtual consultation session

Healthy and Safe Environment Concerns

Is your home safe for children? : Answered: Yes

Child Development Concerns

Health Related Social Needs Concerns

HealthCare Concerns

Getting further training or school or Certification to improve my Health-Related Social Needs (HRSN). Answered: Yes
Did you make a Community Resource-Referral. Answered: Yes
Consultation Duration

Start Time: 2:47 PM
End Time: 2:54 PM
Time Period: 15 mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained

Notes for this Consultation

provider called and said they handed to me a form I will send you the form, need to be filled I need your help.