360° Form 360° Form Gender: MaleFemaleOther Father Name: Father Education: Father Occupation: Mother Name: Mother Education: Mother Occupation: No.Of Siblings: Male: Female: Present Symptoms or Issues (Observed & Narrated by the student) A. Issues related to child (Information from Parents) A.1. Physical Health YesNo A.2. Behaviour Pattern YesNo A.3. Learning-Academic-Difficulties YesNo A.4. Emotional struggles YesNo A.5. Social Isolation YesNo A.6. Trauma and Abuse YesNo A.7. Substance Abuse YesNo A.8. Strongest work skills of your kid A.9. Skills you want to develop in your Kid A.10. List your kid’s significant A.10.1. Activities A.10.2. Hobbies A.10.3. Organizations/Clubs/Groups A.10.4. Reading Interests Previous medical history (Yes/No) if yes, please specify YesNo B. Issues related to child (Information from Teacher) B.1. Physical Health YesNo B.2. Behaviour Pattern YesNo B.3. Learning-Academic-Difficulties YesNo B.4. Emotional struggles YesNo B.5. Social Isolation YesNo B.6. Trauma and Abuse YesNo B.7. Substance Abuse YesNo B.8. Strongest work skills of your kid B.9. Skills you want to develop in your Kid B.10. List your kid’s significant B.10.1. Activities B.10.2. Hobbies B.10.3. Organizations/Clubs/Groups B.10.4. Reading Interests C. Issues related to child (Information from Peer Person) C.1. Physical Health YesNo C.2. Behaviour Pattern YesNo C.3. Learning-Academic-Difficulties YesNo C.4. Emotional struggles YesNo C.5. Social Isolation YesNo C.6. Trauma and Abuse YesNo C.7. Substance Abuse YesNo C.8. Strongest work skills of your kid C.9. Skills you want to develop in your Kid C.10. List your kid’s significant C.10.1. Activities C.10.2. Hobbies C.10.3. Organizations/Clubs/Groups C.10.4. Reading Interests