The document is an individualized intervention plan for a student. It includes the student's name, school, class, and age. It evaluates the student's initial knowledge in different academic areas. It sets long-term objectives and breaks them down into shorter-term objectives to work on over periods of time through learning activities that will be evaluated.

1. PLAN DE INTERVENȚIE INDIVIDUALIZAT
NUMELE ŞI PRENUMELE ELEVULUI__________________________
SCOALA________________________________________________CLASA_______________VARSTA_________
EVALUAREA INŢIALĂ A CUNOŞTINŢELOR ELEVULUI:
Aria curriculară .........................................................................................
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__________________________________________________________________________________________
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OBIECTIVE PROPUSE PE TERMEN LUNG:
__________________________________________________________________________________________
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OBIECTIV
PE
TERMEN
LUNG
OBIECTIV PE TERMEN SCURT PERIOADA ACTIVITĂȚI DE ÎNVĂȚARE EVALUARE