Documente Academic
Documente Profesional
Documente Cultură
Numele şi prenumele
rezidentuluilui:_________________________________________________________________
Locul şi data
naşterii:______________________________________________________________________
CNP:________________________________________________________________________
Fiul/fiica lui:___________________________________________________________________
Domiciliul stabil:_______________________________________________________________
Reședința____________________________________________________________________
Studii:____________________________________Ocupția:____________________________
Diagnostic____________________________________________________________________
Dispozitie de internare
nr.______________/_______________ Căminul pentru persoane vârstnice ”Ing. Vadim
Rusu”
Stare civilă________________________ Nr. copii____________________________________
Manager de caz:
____________________________________________________________________________
Echipa multidisciplinară:
Componență:
Specialitatea:
1. Asistent social Asistentă socială
2. Asistent medical Asistent medical
generalist
3. Medic Medicină de familie
4. Psiholog Psihologie
5. Animator Animație socio-
educativă
6. Infirmieră
7. Personal voluntar: preot Teologie pastorală
SECŢIUNI :
NOTĂ:
1. Servicii sociale:
Observaţii:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
________________________________________
Manager de caz,
Asistent social,
1. Servicii medicale:
2. Servicii de recuperare:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Observaţii:
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
MANAGER DE CAZ:
Medic,
Observaţii:
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_________________________________________________
____________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
__________________________________________________________
Manager de caz,
Asistent social,
Tipul ieșirii:
a. Transfer la o altă unitate de asistență socială
b. Reintegrare în familie (locuința proprie etc.)
c. Deces
d. Alte situații (trai independent în comunitate etc.)
_____________________________________________________________________________________
___________________________________________________________________
a) beneficiarul
b) familia
c) alţi susţinători legali: _________________________________________________________
d) alte instituţii: ________________________________________________________________
e) alte situaţii: ________________________________________________________________
Estimarea posibilităţii de ieşire :