PROJECT TEACH
SETS OF DATA BEING COLLECTED
Initial Evaluation (Physical Therapy, Occupational Therapy, Speech Therapy, SPED)
1. Name
2. Address
3. Age
4. Birthdate
5. Contact. No
6. Gender
7. Diagnosis
8. School address
9. Relevant medical document, if applicable
Medical History Form
1. Name
2. Address
3. Age
4. Gender
5. Birthdate
6. Citizenship
7. Contact no.
8. Parentâs Name/s
9. Siblings name
10. Annual income
11. Relevant medical document, if applicable
Alituntunin Form
1. Name (Parentâs name & child)
2. Signature