UNIUNEA EUROPEANA

Ministerul Administratiei si Internelor

Ministerul Administratiei si Internelor

Proiect finantat de
UNIUNEA EUROPEANA

Directia Schengen

Oficiul Roman pentru Imigrari

JRS Romania

Organizatia Salvai Copiii ERF/10.01/02.01

Nr. dosar
__________________

A 1. Activiti de asisten direct

Subactivitatea
A 1.2. Evaluare nevoi

A 1.9. Viaa social/cultural

A 1.5. Asisten medical

A 1.6. Asisten social

A 1.7. Limba i cultura romn

FIA DE ASISTEN
Nume i prenume ______________________________________________________________________
Nevoi exprimate de beneficiar:
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(Datele completate cu privire la nevoile exprimate sunt cele declarate de beneficiar)

Tipuri de activiti ntreprinse:

Informare

Consiliere

Identificare servicii sociale

Identificare servicii medicale

Identificare servicii educaionale

Alt tip de asisten acordat:

Asistenta accesare servicii medicale si asigurari

Asistenta accesarea beneficiilor sociale

Asistenta accesare module limba romn

Implicarea n activiti recreative/culturale

Accesarea sistemului educaional

Detaliere activiti ntreprinse:

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1

UNIUNEA EUROPEANA

Ministerul Administratiei si Internelor

Ministerul Administratiei si Internelor

Proiect finantat de
UNIUNEA EUROPEANA

Directia Schengen

Oficiul Roman pentru Imigrari

JRS Romania

_____________________________________________________________________________________
_____________________________________________________________________________________
Tipuri de subvenionari acordate:
Subvenionare (A 1.5.)
Tratamente medicale
consultaii medicale

medicamente
asigurari medicale

parial

integral

integral
parial

nr. luni:
perioada
/

Total costuri acoperite: __________________

Subvenionare (A 1.6.)
pachet asisten material

nr. luni:
perioada
/

Total costuri acoperite: __________________

Subvenionare (A 1.7.)
rechizite

integral
parial

nr. luni:
perioada
/

Total costuri acoperite: __________________

Recomandarile i / sau concluziile consilierului:
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Consilier pentru tineret,
_____________________________
(nume si prenume)
_________________________
(semnatura)
Data /...../...../......../
Locul
Centrul Regional ________________________
Data intrrii n asisten ____________ Data i motivul ieirii din asisten ____

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