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Formular fisa Psihologica

FISA PSIHOLOGICA

 

Nume .............…………………….... Prenume ...……………............ Data nasterii ............…………

Tipul de dizabilitate ..………………………………….....................................................…………………………………….

Dizabilitati asociate .................................…………………………………......................……………………………………..

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Dezvoltarea senzorial – perceptiva ......................................…………………………...………………………………………..

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Nivelul dezvoltarii psiho-motricitatii ....................................……………………………..…………………………………….

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Nivel de dezvoltare intelectuala (varsta de dezvoltare, coeficient de dezvoltare) - se precizeaza testul/proba psihologica folosita)

I. Gandirea (inclusiv nivelul operational) .......................…………………………...........……………………………………..

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II. Memoria ..............................................................……………………………………..……………………………………..

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III. Atentia .........................................................…………………………………….........…………………………………….

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Nivelul I de cunoastere

Imaginatia ..............................................……………………………………...................………………………………………

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Limbajul si comunicarea ...................................................……………………………...………………………………………

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Afectivitate .....................................................……………………………………............……………………………………..

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Motivatie ..........................................……………………………………..........................……………………………………..

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Temperament ...........................................………………………………........................……………………………………….

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Vointa .......................................…………………………………….................................……………………………………...

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Atitudini ...................................................………………………………………...............……………………………………..

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Aptitudini .....................................................……………………………………..............……………………………………...

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Nivelul maturizarii psihosociale ................................……………………………............……………………………………...

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Profilul psihologic ......................................…………………………………....................……………………………………..

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Recomandari psihologice ...................................……………………………..................………………………………………

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Data completarii…………….                                                                           Psiholog, 

Regulament (UE) nr.679/2016 privind protectia persoanelor fizice in ceea ce priveste prelucrarea datelor cu caracter personal si privind libera circulatia acestor date si de abrograre a Directivei 95/46/CE.

Responsabilul cu protectia datelor :

Anna-Maria Stamate

email:Responsabildate@dgaspc-cl.ro

Telefon:0242317985

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