Fisa de Evidenta a Persoanelor Consiliate

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    FI DE EVIDEN

    Data:______________ Nr._____

    I. Numele i prenumele:_____________________________________________________________ Vrsta:_________________________________________________________________________

    Sex:___________________________________________________________________________ Studii (profil):___________________________________________________________________ Mediul de provenien:____________________________________________________________

    II. Profesia prinilor: mama________________________________________________________ tata ___________________________________________________________Tipul familiei:_____________________________________________________________________

    III. Starea actual a sntii:________________________________________________________ Antecedente: __________________________________________________________________

    IV. Motivul pentru care s-a prezentat la cabinetul de consiliere:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

    ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

    ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

    CENTRUL JUDEEAN DE RESURSE IASISTEN EDUCATIONAL

    TELEORMAN

    CABINETUL DE ASISTEN PSIHOPEDAGOGIC

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    Data Activitatea desfurat Interpretare/Observaii

    Profesor psiholog,