Fia copilului

Nume __________________________________________________________________________
Prenume ________________________________________________________________________
Vrst _____________________ Data naterii ________________________________________
coala __________________________________________________________________________
1. Sarcina ______________________________________________________________________
2. Naterea _____________________________________________________________________
3. Indicele Apgar ________________________________________________________________
4. Antecedente, predispoziii morbide ________________________________________________
5. Boli cronice __________________________________________________________________
6. Accidente ____________________________________________________________________
7. Lateralitate ___________________________________________________________________
8. Sntatea prinilor, frailor ______________________________________________________
________________________________________________________________________________
Locul unde a crescut (prini sau bunici) _______________________________________________
Persoane de referin din viaa copilului (cu cine a crescut pn la vrsta colarizrii) ___________
________________________________________________________________________________
Tipul de familie din care provine copilul _____________________________________________
a) prinii i eventual bunicii (profesie i nivel de studiu)
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
b) fratria i alte persoane aflate n legtur strns;
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Membrii familiei
Nume
Prenume

Data
naterii

Studii

Evoluia reuitei colare:

1

Loc de munc

Clasa

Anul colar

Media

coala

Localitatea

nvtor (diriginte)

Separri de mediul familial motive, circumstane, durat, reacii ale copilului, contacte cu prinii)
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Evenimente marcante pentru copil i familia sa (decese, separarea prinilor, divor etc.)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

vrsta mersului _________________________________________________________________

etapele ulterioare _______________________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________

regresiile ______________________________________________________________________

dezvoltarea limbajului ___________________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________

alte informaii __________________________________________________________________

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
________________________________________________________________________________
Integrarea social a copilului

 Gradul de integrare n colectivul clasei ___________________________________________

_____________________________________________________________________________
Poziia i rolul copilului n grupul clasei __________________________________________
_____________________________________________________________________________
Colegii preferai _____________________________________________________________
_____________________________________________________________________________
Colegii antipatizai ___________________________________________________________
_____________________________________________________________________________
Tipul de relaii n grupul clasei (cooperare, comunicare, dominare, supunere etc.) _________
_____________________________________________________________________________
Autonomia social ___________________________________________________________
Gradul de integrare a copilului n alte grupuri (familie, prieteni etc.) ___________________
Numr de edine stabilite _________________________________________________________
Concluzii/observaii_______________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________