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Visit Date: September 25, 2021 ID Number: 153113
Visit Count: Children Served: 1 Community Health Worker: SIC Other Staff

Consultation services Delivered

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

How to prevent the spread of illness: Answered: Yes

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
Child Caregiver relationship. Answered: Yes
Caregiver of Child relationship. Answered: Yes
Resource-Referral Type(s).
Family and community support, Education, Disabilities, Covid 19 Related Information
Consultation Duration

Start Time: 5:42 PM
End Time: 7:05 PM
Time Period: 60+mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained

Notes for this Consultation

Provider stressed about grandchild getting covid-19 and infecting her when he returns to inperson school. Assistance with writing child RRA LETTER to school based on her Provider health status.