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Visit Date: October 9, 2021 ID Number: 153360
Visit Count: Children Served: 2 Community Health Worker: Seyhun

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

Safe Sleep: Answered: Yes
First Aid: Answered: Yes
CPR: 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
Consultation Duration

Start Time: 3:45 PM
End Time: 4:05 PM
Time Period: 30 mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained

Notes for this Consultation

Required and completed provider intake with focus on safe sleep, first aid, cpr.