Fişa de Examinare Nr.

________
(pentru elevii din grupul de remediere)

1. Numele şi prenumele_________________________________________, vîrsta__________

2. Şcoala ____________________________________________________, clasa ___________
3. Scopul examinării ____________________________________________________________
_____________________________________________________________________________
4. Date despre familie ___________________________________________________________
_____________________________________________________________________________
5. Relaţii interpersonale în familie _________________________________________________
_____________________________________________________________________________
6. Sfera emoţională _____________________________________________________________
_____________________________________________________________________________
7. Situaţia şcolară ______________________________________________________________
_____________________________________________________________________________
8. Relaţii cu colegii _____________________________________________________________
_____________________________________________________________________________
9. Trăsături de caracter __________________________________________________________
_____________________________________________________________________________
10. Atracţii patologice ___________________________________________________________
11. Interese ___________________________________________________________________
12. Rezltatele inverstigaţilor______________________________________________________
_____________________________________________________________________________
13. Program de dezvoltare şi remediere psihologică ___________________________________
___________________________________________________________codul_____________
14. Termeni de realizare _________________________________________________________
_____________________________________________________________________________
15. Concluzii cu privire la rezultatele participării la şedinţele de dezvoltare şi remediere
psihologică ____________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
16. Recomandări generale ________________________________________________________
_____________________________________________________________________________
____________________________________________________________________________
1
 Rezultatele investigaţiilor
Data, testul Rezultatele obţinute Note
Testare

Retestare

Psiholog _______________________________ semnătura_____________________