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Visit Date: November 13, 2021 ID Number: 153378
Visit Count: Children Served: Provider opted out of answer Community Health Worker: Asha

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
Safe Sleep: Answered: Yes

Child Development Concerns

Health Related Social Needs Concerns

Immunizations and Well Child Schedules. Answered: Yes
Hand-washing – diapering – toileting. Answered: Yes
Social/Emotional development. Answered: Yes

HealthCare Concerns

Taking care of yourself (Whole Person). Answered: Yes
Coping with stressful situations. Answered: Yes
Resource-Referral Type(s).
Utility help needs, Covid 19 Related Information
Consultation Duration

Start Time: 4:14 PM
End Time: 5:15 PM
Time Period: 60+mins

Goals

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

Notes for this Consultation

Dropped some diapers to the providers door and called her to retrieve.