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Parent Questionnaire *
What is your child's nap routine?
What are your child's favorite activities? Check all the apply.
What is your child's birth date?
MM
/
DD
/
YYYY
On a scale of 1-5, rate the difficulty of potty training your child.
easy
hard
Clear selection
Has your child ever been in a child care or group setting? *
Day care or child care center
Submit
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