Sunteți pe pagina 1din 3

Dosar nr.

_____________ Data nregistrrii_______________ Data evalurii ________

FIA PSIHOLOGIC

Nume i prenume copil ___________________________ Data naterii ____________


Tipul de dizabilitate ___________________Dizabiliti asociate____________________
_____________________________________________________________________
Percepie
______________________________________________________________________
Psihomotricitate
______________________________________________________________________
Procesele cognitive
Se precizeaz proba psihologic folosit / metoda de investigare
1. Gndirea (vrsta de dezvoltare, coeficient de dezvoltare - inclusiv nivelul operaional)
____________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
2. Memoria
________________________________________________________________
___________________________________________________________________
___________________________________________________________________
3. Atenia ________________________________________________________________
___________________________________________________________________
__________________________________________________________________
Limbajul i comunicarea
________________________________________________________________
___________________________________________________________________
___________________________________________________________________

Dezvoltarea emoional
_________________________________________________________________
___________________________________________________________________
__________________________________________________________________
Nivelul maturizrii psihosociale
__________________________________________________________
__________________________________________________________________
___________________________________________________________________
Temperamentul
______________________________________________________________________
Imaginaia
_____________________________________________________________________
Profilul de personalitate
________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Recomandri
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
______________________
Numele psihologului / psihopedagogului __________________ Semntura _________
ef serviciu __________________________________ Semntura _______________