CENTRUL JUDEȚEAN DE RESURSE

ȘI ASISTENȚĂ EDUCAȚIONALĂ
IALOMIŢA
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PROTOCOL DE CONSILIERE / ACORD DE COLABORARE

Încheiat între : Dl / Dna SANDU ELENA, profesor consilier la CJRAE Ialomiţa şi Dl / Dna
__________________________________ părinte/tutore legal al elevului
_______________________________, în vederea asigurării calităţi serviciilor de consiliere şcolară
şi asistenţă psihopedagogică oferite de CJRAE Ialomiţa.

Motivul solicitării: □ dezvoltare personală,□ stimă de sine scăzută, □ informare, □ educaţie pentru
sănătate, □ educaţie pentru carieră,□ consiliere vocaţională, □ eşec şcolar, performanţe şcolare
scăzute, □ abandon şcolar,□ evaluare psihopedagogică, □ dificultăţi de învăţare, □ dificultăţi de
relaţionare,□ probleme de comunicare, □ probleme comportamentale : agresivitate, hiperactivitate, □
tulburări emoţionale (anxietate, depresie),□ comportamente şi atitudini deviante, □ dileme morale, □
dificultăţi în luarea deciziei şi asumarea responsabilităţii, □ scăderea capacităţii de adaptare la
realitate,□ dezvoltarea abilităţilor sociale-asertivitate, □ controlul stresului, □ managementul
timpului, □ abuz emoţional, abuz fizic, □ intervenţie în situaţii de criză : divorţ, boală, decesul
părintelui,□ prevenţia suicidului,□ asistenţă
socială,□ alte cazuri: _______________________________________________________________
Contractul de consiliere încheiat între reprezentantul beneficiarului (părinte / tutore legal) şi
consilier.

Semnătura profesorului consilier Semnătura părintelui/ tutorelui

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Strada Viilor, Nr. 61

Slobozia, Judeţul Ialomiţa
Telefon/Fax: 0243232144
E-mail: cjraeialomita@yahoo.com
 CENTRUL JUDEȚEAN DE RESURSE
ȘI ASISTENȚĂ EDUCAȚIONALĂ
IALOMIŢA
________________________________________________________________________

Beneficiar: ____________________________________

1. Analiza situaţiei prezente ( scurtă descriere), definirea problemei, identificarea obiectivelor :

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2. Planul de consiliere :
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Strada Viilor, Nr. 61

Slobozia, Judeţul Ialomiţa
Telefon/Fax: 0243232144
E-mail: cjraeialomita@yahoo.com
 CENTRUL JUDEȚEAN DE RESURSE
ȘI ASISTENȚĂ EDUCAȚIONALĂ
IALOMIŢA
________________________________________________________________________

3. Tipul de intervenţie:
o Consiliere individuală
o Consiliere de grup
o Testare şi evaluare psihologică
o Informare
o Altele _________________________________________________________________

4. Perioada :

5. Recomandări :
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Strada Viilor, Nr. 61

Slobozia, Judeţul Ialomiţa
Telefon/Fax: 0243232144
E-mail: cjraeialomita@yahoo.com
 CENTRUL JUDEȚEAN DE RESURSE
ȘI ASISTENȚĂ EDUCAȚIONALĂ
IALOMIŢA
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Strada Viilor, Nr. 61

Slobozia, Judeţul Ialomiţa
Telefon/Fax: 0243232144
E-mail: cjraeialomita@yahoo.com