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• Tania Fitch

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FORMATO DE ENTREVISTA INICIAL DEPARTAMENTO DE PSICOLOGÍA COLEGIO MÉXICO EMPRENDE Nombre de alumn@: ____________________________________________________________ Edad:_________________ Grado y Grupo:_____________________ Fecha de nacimiento______________________ Fecha de aplicación:_________________ MOTIVO CONSULTA: ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ _______________________________________________________________________________________________________-______ APARIENCIA Y OBSERVACIONES CONDUCTUALES: ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ DINAMICA Y ESTRUCTURA FAMILIAR (CON FAMILIOGRAMA). **Miembros, relaciones, con quién vive.

HISTORIA ACADEMICA Y ESCOLAR. (calificaciones, cambios de escuela, momentos significativos para el niño) ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ DESARROLLO SOCIAL ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ RECREACIÓN Y ACTIVIDADES ARTÍSTICAS Y CULTURALES ______________________________________________________________________________________________________________ ____________________________________________________________________________________________________ OBSERVACIONES Y ASPECTOS A TRABAJAR EN SESIÓN POSTERIOR ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________

FORMATO DE SEGUIMIENTO FECHA__________________________ Nombre del alumn@:___________________________________ Grado y Grupo_______________ OBJETIVOS DE LA SESIÓN: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ APARIENCIA Y CONDUCTAS OBSERVABLES ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ SÍNTESIS DE LA SESIÓN: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ CONCLUSIONES: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ TAREA PARA LA PRÓXIMA SESIÓN ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________