The collection of data related to patients non-medical needs through use of Social Determinant of Health (SDoH) assessment tools, can accelerate systemic population health improvement, as well as engage patients in addressing their social non-medical needs (such as transportation, shelter, or intimate partner violence services) through coordinated access to appropriate services or community-based supports. This case study discusses the process a health center may use to identify and stratify need, and profiles a number of community referral platforms, including Aunt Bertha, Now Pow, and 211 Community Information Exchange for connecting patients to appropriate community resources.