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CENTRO DE SALUD MENTAL COMUNITARIO TAYACAJA

HISTORIA CLINICA SALUD MENTAL

NOMBRE USUARIO___________________________________________ N° HC: _____________

l. PROBLEMA ACTUAL
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OBSERVACON DE LA CONDCTA
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AFECTIVA:_____________________________________________________________________________________
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COGNITIVA:____________________________________________________________________________________
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SOCIAL:_______________________________________________________________________________________
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EVALUACION PSICOLOGICA:

PERSONALIDAD:________________________________________________________________________________
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INTELIGENCIA:_________________________________________________________________________________
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HABILIDADES:__________________________________________________________________________________
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MPRESIÓN DIAGNÓSTICA
PRESUNTIVA:__________________________________________________________________________________
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INTERVENCION PSICOTERAPEUTICA A SEGUIR:
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CENTRO DE SALUD MENTAL COMUNITARIO TAYACAJA
HISTORIA CLINICA SALUD MENTAL

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PROGRAMA DE INTERVENCION

Sesión No. ________ Fecha: ______________________


Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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___________ PROX. CITA______________
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SELLO PERSONAL QUE ATENDIO

Sesión No. ________ Fecha: ______________________


Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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SELLO PERSONAL QUE ATENDIO
Sesión No. ________ Fecha: ______________________
Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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SELLO PERSONAL QUE ATENDIO
Sesión No. ________ Fecha: ______________________
Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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___________ PROX. CITA______________
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SELLO PERSONAL QUE ATENDIO

Sesión No. ________ Fecha: ______________________


Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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___________ PROX. CITA______________
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SELLO PERSONAL QUE ATENDIO
CENTRO DE SALUD MENTAL COMUNITARIO TAYACAJA
HISTORIA CLINICA SALUD MENTAL

Sesión No. ________ Fecha: ______________________


Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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___________ PROX. CITA______________
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SELLO PERSONAL QUE ATENDIO
Sesión No. ________ Fecha: ______________________
Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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___________ PROX. CITA______________
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SELLO PERSONAL QUE ATENDIO

Sesión No. ________ Fecha: ______________________


Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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___________ PROX. CITA______________
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SELLO PERSONAL QUE ATENDIO
Sesión No. ________ Fecha: ______________________
Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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___________ PROX. CITA______________
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SELLO PERSONAL QUE ATENDIO
Sesión No. ________ Fecha: ______________________
Objetivo:__________________________________________________________________________________
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Descripción:________________________________________________________________________________
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___________ PROX. CITA______________
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SELLO PERSONAL QUE ATENDIO