| Visit Date: February 10, 2022 | ID Number: 153378 | ||
| Visit Count: | Children Served: Provider opted out of answer | Community Health Worker: Asha | |
Consultation services Delivered |
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| What type of Consultation was it? Collaborative Collateral Contact | |||
| Did you make a Child Development Referral (Not Screening) * Answered: Yes | |||
| 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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| Is your home safe for children? : Answered: Yes | |||
| Safe Sleep: Answered: Yes | |||
Child Development Concerns |
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Health Related Social Needs Concerns |
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HealthCare Concerns |
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| Resource-Referral Type(s). Utility help needs, Covid 19 Related Information |
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| Consultation Duration Start Time: 8:13 AM End Time: 9:15 AM Time Period: 60+mins |
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Goals |
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| Progress Made Towards Goal?: No | |||
| Goal Attained? No | |||
| Progress made towards goal? | |||
Notes for this Consultation
Enrolled the provider in utility discount program
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