This two-page Social Needs Screening Tool is available in both English and Spanish. It asks patients to identify social needs so staff can refer them to case management for resources. The information is confidential and shared only with the care team. Completion is voluntary, and patients can decline or indicate no need for services. It also states that patients should contact their CMC care team if their situation changes.
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SDoH Screening Pictogram with Instructions
December 3, 2025