Fi de anamnez psihologica

Numele i prenumele: _________________________________________________________________

Data, an natere, localitate: _____________________________________________________________
Domiciliul stabil al prinilor: ___________________________________________________________
Profesia: ____________________________________________________________________________
Vechimea in functie: __________________________________________________________________
Experienta profesionala: _______________________________________________________________
Studii anterioare: _____________________________________________________________________

1. Date asupra mediului familial structura familiei

a. Familia
Numele membrilor
familiei
Tata

Varsta
parintilor
la nastere

Data
naterii

Pregtire
a colar

Profesiunea

Venituri

Observaii

Mama
Frai

b. Atmosfera n familie (relaiile de familie cu persoane ce dispun de functii importante; regim i

climat educativ, climat afectiv etc.):
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c. Ordinea in fratrie:
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d. Proiectele prinilor privind viitorul copilului( influenta parintilor va arata gradul de
sugestibilitate, de dependenta sau de maturizare:
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2. Date privind activitatile de joaca:

a. Grupul de joaca (varsta 3-5 ani) existenta si structura grupului (detalii despre calitatile
relationale si comunicationale):
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b. Preferinta pentru anumite meserii in timpul jocului:
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c. Pozitia subiectului fata de lider (fata de autoritate):
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3. Date asupra colaritii (perioada adolescentei 16-18 ani) afirmarea Eului, structurarea
liniei si a idealului de viata
a. Situaia colar in urma studiului fisei scolare:
Obiecte cu rezultate
Clasa

Secia

Media anual

Mai bune

Mai slabe

Repetene,
corigene

a IX-a
a X-a
a XI-a
a XII-a
b. Succese deosebite la concursuri:
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c. Manifestri n timpul leciei (atenie, receptivitate, participare la discuii frecvena i valoarea
intervenirii etc.):
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d. Modul de pregtire a leciilor (cu regularitate, din proprie iniiativ, prin efort propriu etc.):
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e. Eficienta scolara (comportamentul invatarii, cu sau fara strategii de invatare)
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f. Chiulul (absenta sau prezenta lui):

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g. Factorii explicativi ai succesului sau ai insuccesului (aptitudini, srguin, interes, deprinderi de
munc, lacune n pregtirea colar, aspiraii profesionale, stare de sntate, condiii de mediu
etc.):
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4. Integrarea social a elevului (varsta 3-7 ani adaptarea si integrarea scolara)
A. Conduita n familie:
a. fa de prini (ascultare, ataament, independen, nesupunere etc.)
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b. relaiile cu fraii (ocrotire, nelegere, dominare etc.):
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c. participare la activitatea familiei (autoservire, ajutorare etc.):
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B. Conduita n coal:
a. Relaiile elev profesori (disciplinat, politicos, docil, rezervat, impertinent etc.):
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b. Atitudinea pozitiva/ negativa fata de acea perioada:
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c. Relatia cu persoanele importante (primul invatator, primul diriginte):
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d. Relaiile cu colegii (solidaritate, colegialitate, prietenie, rezerv, tendin de dominare sau de
supunere, egoism, apreciere, influena lui n cadrul colectivului etc.):
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e. Interese manifestate pentru anumite meserii:
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C. Conduita ntre prieteni (natura prietenilor, rolul n grup, influene asupra elevului etc.):
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5. Caracteristicile personalitii
a. Procese intelectuale (nivel de dezvoltare intelectual, memorie, gndire, imaginaie, limbaj etc.):
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b. Trsturi de afectivitate (sentimente legate de personalitate, reacii fa de succes i insucces,
sensibilitate, timiditate, echilibru emotiv etc.):
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c. Aptitudini, interese, aspiraii evideniate prin activitile colare i preocuprile din timpul liber
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d. Increderea in sine (inalta capacitate de evaluare, autoreglare si actiune, stare de spirit optimista,
stenica, siguranta in reusita proprie si colectiva):
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6. Trsturi de temperament:
a. Energie (capacitate de efort, rezisten la oboseal), mobilitate (ritm de activitate, adaptare la
situaii noi) i echilibru psihic (stpnire de sine impulsivitate):
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b. Introversiune (nchis, retras) extraversiune (deschis, sociabil): - deschis disponibilitatea de asi relata obiectiv si sincer trecutul:
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c. Atitudine fa de societate i de oameni ( comportare civilizat, solicitudine, ataament fa de
colectiv, onestitate etc.):
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d. Atitudine fa de sine (demnitate, modestie, spirit autocritic etc.):
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7. Aprecieri de ansamblu
a. Pregtirea raportat la aptitudini, starea de sntate i condiii de munc:
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b. Gradul de maturizare psihic (intelectual, afectiv, temperamental):
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8. Conduita in munca
a. Relatia subordonat sef:
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b. Relatiile cu colegii de munca:
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c. Integrarea in organizatie (conformism):
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d. Eficienta obtinuta in organizatie:
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e. Interesul profesional:
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Observaii raport (profilul psihologic):
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