PSYCHOLOGICAL TESTING

(Personal Background)

QUESTIONNAIRES:

A. Family History

Client’s Background

Name: Hannah Erika L. Valdez Course/year: BS Psychology; 3rd year

Age: 21

Birth place: Antipolo City Birth date: March 26, 2001

Family Background

Father’s Name: Eric T. Valdez Occupation: Project Engineer

Age: 56

Mother’s Name: Ma. Paz L. Occupation: Housewife

Valdez
Age: 49

Siblings:
Name Age Occupation
Ira Nicole L. Valdez 20 Student
Francis Ericson L. Valdez 18 Student
Jan Manfred L. Valdez 17 Student
B. Domestic Environment

*Where you grew up?

*How’s Family?

*Are you close to your family?

*What will parents do to discipline you?

*What is your parents work? Are they working abroad?

C. Physical History

*Is the pregnancy planned?

*During pregnancy, did the mother have some addiction?

*Is the mother work during pregnancy? What is her work? How long?

*What is the nature of delivery? Normal or caesarean?

*How big is he/she? (lbs) during pregnancy.

*Was he/she in a proper condition?

*When was the first time that he/she (dumapa, umupo, tumayo, kumain mag-isa,
naglakad, maligo mag-isa sa anong edad?
D. Significant Health

*Simula pagkabata na-hospital ba sya? What age? Anong sakit? How long? (If yes why?)

*Accidents during early stage?

E. Behavioural and Environmental History

*How does he/she cope up whenever scolded?

*Does he/she play or prefer to be alone?

*What he/she do every time he/she doesn’t get what he/she wants?

*Does he/she have mannerism?

F. Social and Environmental History

*Where did you study in grade school and high school?

*What is your favourite subject?

*Extra-curricular?

*Do you have friends?