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Visit Date: July 10, 2020 ID Number: 153164
Visit Count: Children Served: Provider opted out of answer Community Health Worker: SIC Other Staff

Consultation services Delivered

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

How to prevent the spread of illness: Answered: Yes

Child Development Concerns

Health Related Social Needs Concerns

HealthCare Concerns

Taking care of yourself (Whole Person). Answered: Yes
How to help me cover my HRSN (e.g. food, transportation, housing, medical needs, employment). Answered: Yes
Consultation Duration

Start Time: 10:55 AM
End Time: 11:16 AM
Time Period: 15 mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Goal attained?

Notes for this Consultation

Provider had requested food do to food insecurities and mask to prevent getting Covid-19. Both food and mask were delivered to provider.