Psiholog .........................................

FIŞĂ DE CONSILIERE

Numele şi prenumele elevei/elevului: ……………………………………...........................Clasa:.........

Data naşterii:.........................Domiciliul:...................................................................................................
Motivul consilierii:
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Date relevante despre situaţia familială:…………………………........................……………..............
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Date despre dezvoltarea fizică şi starea de sănătate:
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Date despre situaţia şcolară:
Discipline şcolare preferate……………………………………………..........................................………
Discipline şcolare mai puţin preferate:………………………………………............................................
Activităţi extraşcolare relevante:…………………………………..............................................................
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Conduita la lecţie şi în clasă:
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Relaţii interpersonale:
-cu
colegii: .........................................................................................................................................................
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-cu
dirigintele: ...................................................................................................................................................
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 -cu
profesorii: ....................................................................................................................................................
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Date psihologice semnificative:

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Activitatea de consiliere:
Nr. Data Obiective Metode/instrumente utilizate
şedinţei

Rezultatele activităţii de consiliere:

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