FIA PRIMEI CONSULTAII

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Numele copilului, vrsta _________________________________ Specialist _______________________

Numele prinilor ________________________________________________________________________

Date de contact: tel. ___________________________ e-mail ____________________________________

Diagnostic oficial ________________________________________________________________________

Instituia precolar/colar pe care copilul o frecventeaz _______________________________________

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Centre de dezvoltare frecventate ___________________________________________________________

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Dac a fost copilul deja implicat ntr-un program terapeutic (durata, specialitii, modalitatea de lucru,
rezultate) ______________________________________________________________________________
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Recomandri primite de prini pn n prezent cu privire la interaciunea cu copilul i procesul de nvare

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Vasile Pitel www.vasilepitel.md

Dificulti pe care le ntmpin copilul n viaa de zi cu zi (din spusele prinilor)
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Ateptrile pe care le au prinii de la procesul de terapie

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Vasile Pitel www.vasilepitel.md

Notele specialistului cu privire la comportamentul copilului i abilitile posedate (ducnd observaii)
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Vasile Pitel www.vasilepitel.md

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Vasile Pitel www.vasilepitel.md