PREFEITURA DE CAMPESTRE – MG

Centro de Referência Especializado de Assistência Social

(CREAS)

ANAMNESE SOCIAL

Nome: ______________________________________________________Idade: _______

Responsável: ______________________________________________________ Data:

_____/_____/_____

1)
Violência:____________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

2) Infância/adolescência:_________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

3) Família:_____________________________________________________________________

_____________________________________________________________________________
_____________________________________________________________________________

4) Trabalho/escola/comunidade:___________________________________________________

_____________________________________________________________________________
_____________________________________________________________________________

5) Saúde:______________________________________________________________________

_____________________________________________________________________________
_____________________________________________________________________________

6)
Lazer:_______________________________________________________________________

_____________________________________________________________________________
_____________________________________________________________________________
7) Sentimentos sobre a violência: _____________________________________________

_____________________________________________________________________________

Rua São José, 326 – Centro - 37550-000 – Pouso Alegre/MG -  (35) 3449-4247
 PREFEITURA DE CAMPESTRE – MG

Centro de Referência Especializado de Assistência Social

(CREAS)

________________________________________________________________________

Rua São José, 326 – Centro - 37550-000 – Pouso Alegre/MG -  (35) 3449-4247