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Visit Date: January 4, 2021 ID Number: 153270
Visit Count: Children Served: 2 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

How to prevent the spread of illness: Answered: Yes

Child Development Concerns

Health Related Social Needs Concerns

Hand-washing – diapering – toileting. Answered: Yes

HealthCare Concerns

Taking care of yourself (Whole Person). Answered: Yes
Resource-Referral Type(s).
Covid 19 Related Information
Consultation Duration

Start Time: 12:05 PM
End Time: 12:34 PM
Time Period: 30 mins

Goals

Progress Made Towards Goal?:
Goal Attained?
Progress made towards goal?

Notes for this Consultation

Provider wanted to be tested for COVID-19. Provider Requested information on free Covid testing sites. Provided provider a list of testing sites near their zip code.