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Driver Request- General Doctor's Appointment

Wednesday, August 10 2022

Date of Appointment: 8/10/22
Appointment Time: 12:45pm
Pickup Address: 8500 Harwood Rd. #3315, North Richland Hills, 76180

Facility and Doctor Name: JPS Family Health Clinic (4th floor)

Documents Needed: Insurance cards, ID
Car Seats Needed? (located at the Fort Worth office) No
Estimated time of entire appointment: 3 hours

Full Client Name (s), Gender and Birthday: Khwaja Shah Sediqi, M, 12/5/1979
SEDIQI, Hasanat, F 6/11/2012
SEDIQI, Khwaja Arash, M 6/11/2012
Sediqi, Yousuf, M, 9/6/2009
Case number: HB-119396
How Many Adults/Children: 1 adult, 3 children

Case Worker name and number for volunteer questions: Noelle Foster, 817-936-0591
If possible, on the way home please take the family to Richland Middle School and C.F. Thomas Elementary to provide school with updated shot records.

Volunteer’s Notes from the appointment:

12:45pm - 3:00pm
JPS Family Health Clinic (1500 S Main St 4th Floor, Fort Worth)
1 / 1
Full

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