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Date of Birth:
Monica's last name
Guardian/Family Email Address:
How many live in the household?
How many work and/or provide income to support the household?
High risk for developing issues later
Organizations / Mentor Programs:
Big Brother, Wrestling team at school
IEP, daily check-ins with school counselor, 1:1 paraprofessional support
no health concersn
Victim of Sexual Abuse:
Perpetrator of Sexual Abuse:
Victim of Physical Abuse:
was physically abused at age five-six by boyfriend of mother. Police intervention.
Threatening or Aggressive Behavior:
Required Physical Restraint:
Personality / Social Standing:
Joe is very social and extroverted. He is like by all his peers. He does sometimes seek attention through negative behaviors, but this is a focus of his daily work with the school counselor. He has made great strides in the fourth grade.
When he is overwhelmed, he is slow to seek assistance. He may, instead, act out. His caring and well-trained teacher is alert to this and responds directly .
Unlimited and untapped potential.