HOJA DE ENTREVISTA

ALUMNO: _______________________________________________

GRADO: ________ SECCCION: ________ NIVEL: _______________

FECHA: _____/______/ 2011

TUTOR (A):________________________________

ENTREVISTA SOLICITADA POR: ____________________________________

MOTIVO:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

ASPECTOS PRINCIPALES ABORDADOS EN LA ENTREVISTA:

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
_____________________

CONCLUSIONES Y ACUERDOS ADOPTADOS:

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
_____________________

COMENTARIO ADICIONAL:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
_______________________________________

________
TUTOR

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 FICHA ANECDOTICA

ALUMNO: ______________________________________________________

GRADO: ___________ SECCION: ________ NIVEL: ___________________

TUTOR (A):________________________________

FECHA: _____/________/ 2011

DESCRIPCION DEL HECHO:

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
_______________________________________

COMENTARIO:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
________________________________________

RECOMENDACIONES:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
________________________________________

________
TUTOR

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 HOJA DE REGISTRO DE LA TUTORIA

DATOS INFORMATIVOS:

GRADO: _______ SECCION: ____________ NIVEL: _____________________

Nº DE ALUMNOS O GRUPOS: __________

TUTOR: ______________________________________

FECHA: ____/______/ 2011 HORA: ______________

TEMAS TRATADOS:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

LOS TEMAS PROPUESTOS FUERON POR:

___________________________________________________________________
__________________________________________________________________

ACTITUD DEL GRUPO (INCLUIR NIVEL DE INTERÉS, MOTIVACIÓN Y

PARTICIPACIÓN) :
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

ASPECTOS QUE LLAMARON LA ATENCIÓN:

___________________________________________________________________
__________________________________________________________________

ALUMNOS QUE LLAMARON LA ATENCIÓN:

___________________________________________________________________
___________________________________________________________________

PERCEPCIÓN Y OPINIÓN PERSONAL DEL TUTOR:

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

SUGERENCIAS:
___________________________________________________________________
___________________________________________________________________
__________________________________________________________________

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 ________
TUTOR

FORMATO DE DERIVACION DE CASOS (T.O.E)

DATOS PERSONALES:

NOMBRES: _________________________________________________________
EDAD: ________
GRADO Y SECCION: _________ NIVEL ______________________

TUTOR: ____________________________________________
FECHA: ______/______/ 2011
DERIVACION SOLICITADA POR: _______________________________________

MOTIVO DE LA DERIVACION:

Indisciplina recurrente ( ) Conductas inapropiadas ( ), Violencia ( ), Bajo rendimiento ( ),

Incautación de objetos y/o Sustancias prohibidas ( ), Inestabilidad emocional ( ), Abuso
sexual o Maltrato físico ( ), Adicciones “especificar adicción” ( ), Robo o daño a la I.E ( ),
Otros Problemas (______________________________).

ASPECTOS PRINCIPALES ABORDADOS EN LA ENTREVISTA:

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
______________________________________________

INDICADORES DE RIESGO:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
_______________________________________________

CONCLUSIONES Y ACUERDOS ADOPTADOS EN LA ENTREVISTA:

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
_______________________

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 ____________________
TUTOR

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