ficha atencion padres
DESCRIPTION
entrevista padresTRANSCRIPT
I.E.P MENDEL
IEP Nuestra Seora de las GraciasDepartamento de Psicologa Svieta Valia Fernandez Gonzlez, PsiclogaFICHA DE ATENCIN A PADRES DE FAMILIA
Fecha de entrevista _________________________
1. DATOS PERSONALES Apellidos y Nombres: _____________________________________________________ Edad: ____________________Telfonos: _____________________________ Nivel Educativo: ____________________ Ocupacin: __________________________ Centro de trabajo:_________________________ Horario de trabajo: ______________ Parentesco ____________________________________________________________ Nombre del Alumno ____________________________________________________ Nivel, Ao y seccin _________________________________ Consulta ( )Citacin ( ) Otro( ) ___________________
2. MOTIVO DE ATENCIN ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
3. FAMILIOGRAMA
4. DESCRIPCIN DEL PROBLEMA____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
5. CONCLUSIONES____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
6. SUGERENCIAS____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
7. ACCIONES A TOMAR (I.E)
____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________
_______________________________DEPARTAMENTO DE PSICOLOGA