| Visit Date: March 16, 2020 | ID Number: 153164 | ||
| Visit Count: | Children Served: Provider opted out of answer | Community Health Worker: SIC Other Staff | |
Consultation services Delivered |
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| What type of Consultation was it? In-person 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 |
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| How to prevent the spread of illness: Answered: Yes | |||
Child Development Concerns |
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Health Related Social Needs Concerns |
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| Hand-washing – diapering – toileting. Answered: Yes | |||
HealthCare Concerns |
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| Taking care of yourself (Whole Person). Answered: Yes | |||
| Getting further training or school or Certification to improve my Health-Related Social Needs (HRSN). Answered: Yes | |||
| How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes | |||
| Coping with stressful situations. Answered: Yes | |||
| Medication Management Adult (Non Clinical). Answered: Yes | |||
| Consultation Duration Start Time: 11:36 AM End Time: 12:40 PM Time Period: 60+mins |
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Goals |
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| Progress Made Towards Goal?: | |||
| Goal Attained? | |||
| Progress made towards goal? | |||
Notes for this Consultation
Provider is stressed do to being under quarantine, and wasn’t able to pick up medication at the pharmacy. Community health worker picked up medication for provider and dropped off medication at front door.
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