Possible Challenges (Please check the level of difficulty in each item where 1 is the highest and 3 is the lowest)
Academic Challenges 1 2 3
Languages (English, Filipino, MTB-MLE)
Science
Mathematics
Social Sciences (History, Economics, etc.)
Technical-Vocational (TLE)
Technology (Computer)
Health Challenges 1 2 3
Eyes
Ears
Lungs
Heart
Upper Extremities
Lower Extremities
Skin
Nose
Blood
Internal Organs
Lymphatic System
Others, please specify
Psycho-Social Challenges 1 2 3
Self-confidence
Stress tolerance
Emotional quotient
Socialization
Spirituality
Other Challenges 1 2 3
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Recommendations:
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Assessed by:
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Signature over Printed Name
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Date Assessed