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- Sintomas:___________________________________________________________________________
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05- QUEIXAS SECUNDÁRIAS:
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-Casos de internação:
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-Enfrentamento: _______________________________________________________________________
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-Sintomas físicos e/ou psicológicos:________________________________________________________
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- Psicoterapia/fono/fisio/neuro/psiquiatria:
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- Hábitos Alimentares:
- Desenvolvimento Neuropsicomotor:
- Doenças infantis:
- Casos de convulsões,epilepsia,desmaios etc: -
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-Dinâmica Familiar:____________________________________________________________________
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- Eventos Significativos:________________________________________________________________
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-Rede de Apoio:
- Áreas de dificuldade:
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- Hábitos de Estudo:.
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Assinatura do profissional