FICHA DE OBSERVACIÓN

Nombres y Apellidos:…………………………………………………………………………………………………………………..

Grado y Nivel:…………………………………………… Edad:…………. Sexo:…………………………..

Derivado por:………………………………………………………………………………………………………………………………

Responsable:………………………………………………………………………….. Fecha:………………………………..

Motivo de Consulta:
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Conductas observadas dentro del aula:

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Conductas observadas fuera del aula: (E. física, recreo, formación, talleres)
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Actitud del docente frente al problema:

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Variantes: Conductas en casa

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Observador (a)

PSIC.