Entrevista para Laudo Psico

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Local de Trabalho
Serviço Social
 
 
Entrevista
 ENTREVISTA SOCIAL DATA: ___/___/______
Número do Processo: ____________________
Nome: ___________________________________________________________
Idade: ________
Endereço:__________________________________________________________________________________________________________________________
Telefone: ________________________________________________________
Grau de instrução:
( )Analfabeto 
( )Ensino Fundamental _____________________________________ 
( )Ensino Médio _____________________________________ 
( )Ensino Superior _____________________________________ 
Está Cursando? _______________________________________
Trabalha ?
( )Sim ( )Não 
 
Situação de Trabalho:
( ) Formal (regido pela CLT ou Funcionário Público) 
( )Informal (“Bico”, Trabalho Temporário...) 
( )Autônomo 
Profissão ou Ocupação: ________________________________________
Local de Trabalho: ________________________________________
Horário e Dias de Trabalho: _____________________________________ 
Composição Familiar:
___________________________________________________________________________________________________________________________________________________________________________________________________
Nº. de pessoas que contribuem para a Renda: _________________________________________________________________
Recebe algum Auxílio? ______________________________________________
Renda Familiar:
_____________________________________________________________________________
Tipo de Moradia: ( )Próprio ( )Alugado ( )Agregado ( )Cedida 
Por: _____________________________________________________________
Apresenta Problemas de saúde? 
( )Sim ( )Não Quais?_____________________________________________ 
Observações : 
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Técnico Responsável