Student Profile
Student’s Visual Supports:
Name:______________________________
Guardian’s Name: Hearing Supports:
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Case Manager’s Allergies:
Name:______________________________
Grade:_____________________________H Medications:
omeroom:_________________________
Additional Services
O.T/P.T: Yes/No
Day/Time:__________________________________
Speech: Yes/No
Day/time:___________________________________
Adaptive P.E: Yes/No
Day/Time:___________________________________
Behavioural Concerns Medical Concerns
Notes:______________________________ Notes:______________________________
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_______________________________ _______________________________
In School Support In School Support
Staff:_______________________________ Staff:_______________________________
____________________________________ ____________________________________
____________________________________ ____________________________________
____________________________________ ____________________________________
____________________________________ ____________________________________
_______________________________ _______________________________
Student’s Interests:
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Student’s Dislikes:
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Student’s Strengths:
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Student’s Stretches:
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Student Goals
Personal 1) 2) 3)
Social 1) 2) 3)
Academic 1) 2) 3)
Current Up-To-Date Testing:
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Other Important information: