Държавен вестник, бр. 59, 2015 г., стр. 90

СТР.  90	
Д Ъ Р Ж А В Е Н  В Е С Т Н И К 	
БРОЙ  59
Трите имена: .................................................................................................................................................................
Връзка с детето: ............................................................................................................................................................
Подпис: ............................................................................................ Дата: ...................................................................
Дата …………………………….
Гр./с. ……………………….....
Община ………………………
Област ……………………….“
§ 22. Създава се приложение № 3 към чл. 26, ал. 2, т. 5:
„Приложение № 3 
към чл. 26, ал. 2, т. 5
ПРОТОКОЛ № …………/………… г.
от заседание на екипа от специалисти
I. Данни за детето/ученика
Трите имена: ..................................................................................................................................................................
Възраст: ........................................................................... ЕГН: .....................................................................................
Детска градина/група (Училище, клас, паралелка): ..............................................................................................
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Адрес, телефони: ...........................................................................................................................................................
Личен лекар:....................................................................... № ..................................... телефон …….....................……
Място на здравно осигуряване: .................................................................................................................................
II. Психологическа оценка
Оценка на интелектуалното, когнитивното, емоционалното и социалното функциониране
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III. Логопедична оценка
Оценка на говорното, речевото (устна и писмена реч) и езиковото (разбиране, изява) развитие
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IV. Оценка от ресурсен учител
Оценка на необходимостта и начина на адаптиране на съдържанието на програмите/учебните програми 
в зависимост от потребностите на детето/ученика
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V. Функционална оценка на детето/ученика
Становище на екипа от специалисти
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VI. Заключения, възможни решения и действия 
Опишете подробно заключенията, възможните решения и препоръчаните действия
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