Nr............/CIR/..............

FISA DE CONSILIERE PSIHOLOGIC~

Nume şi prenume…………………………………………………………….

Definirea problemei 
……………………………………………………………………………….
……………………………………………………………………………….
………………………………………………………………………………..
……………………………………………………….................................................
.....................................................................................................................................
......................
Resursele clientului
Materiale

……………………………………………………………………………….
……………………………………………………………………………….
…………………………………….............................................................................
............
Afective
……………………………………………………………….....................................
...................................................................................................................................
....................................................................................................................................
....................................................................................................................................

Obiectiv pe termen lung

………………………………………………………………………………………
………………………………………………………………………………………
………………………………………………………………………........................
Obiective specifice
………………………………………………………………………………………
………………………………………………………………………………………
……………………....................................................................................................
………………………………………………………………………………………
………........................................................................................................................

Evaluarea interventiei
………………………………………………………………………………………
………………………………………………………………………………………
……………………....................................................................................................
………………………………………………………………………………………
…………....................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
.....................................................................................................................................
.....................................................................................................................................
.....................................................................................................................................
.....................................................................................................................................
.....................................................................................................................................
.....................................................................................................................................
Psiholog Data

Beneficiar