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School prep screening score sheet
School prep screening score sheet
1
2
Date of interview:
NAME
Date of Birth
Chron.
AGE
Gender
Draw a
Perso
n
-/
10
Wri
tes
Na
me
-
/5
Pencil
Grip
_/3
L
etter Knowledge
/
7
Pictur
e
Re
c’gn
. /
10
Counts
to.
...
/5
No
.
Kno
wl
e
dg
e
/8
Shape Knwldg
/4
Knows col
ours_/1
0
Body Part
s __/
10
Abilit
y to
sit a
nd
Engage _
_/
8
T
otal __/
80
SEP ?
Same Class
as
/
Teacher
Request
[valid
reasons
only.]
&
Other
Consider
ation
s:
SCHOOL PREP INTERVIEW DATA SHEET
for 20XX
Download
School prep screening score sheet
DOC: 142.9 KB | PDF: 164.5 KB (2 pages)
(
4.4
,
20
votes
)
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