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Visit Date: June 8, 2022 ID Number: 153346
Visit Count: Children Served: Provider opted out of answer 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

Child Development Concerns

Health Related Social Needs Concerns

HealthCare Concerns

Consultation Duration

Start Time: 10:00 AM
End Time: 10:45 AM
Time Period: 45 mins

Goals

Progress Made Towards Goal?: No
Goal Attained? No
Goal attained

Notes for this Consultation

I call the client and inform that I am going to deliver food certificate and drove to the client address and replace it at client’s door. And call the client again
for confirmation and she confirmed me that she received the food certificate.