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  • Patient

  • Housing Insecurity

  • Food Insecurity

  • Transportation Insecurity

  • Financial strain/limitation

  • Medical Issue--refer to health center

  • Substance Abuse

  • Sexual Health

    • HIV testing

    • STI testing

    • sexual assault

    • HIV prevention

    • Intimate partner violence

  • COVID template

    • exposure/testing

    • vaccine

    • diagnosis

  • Behavioral Health

  • Other Social Service Need

  • Enroll in Health Center

  • Blank Care Plan