Preschool and Kindergarten Developmental History
The following information would be helpful to us in caring for your child. Thank you for taking the time to answer the following questions.
What do you want us to call your child? (nickname) *
Please list the names and ages of siblings: *
Has your child had experiences in playing with other children? *
Has your child had any previous group experience? *
Does your child know anyone currently enrolled at St. Theresa's?
How does your child usually react to new situations? *
How would you describe your child's personality? *
Does your child have any special fears? *
Is your child right handed or left handed? *
Does your child have a tensional outlet? (thumb sucking, head banging, nail biting, hair pulling) *
How does your child show his/her feelings? *
At what age did your child begin talking? *
Does your child have any speech problems? *
Can your child dress herself/himselt? *
Is there anything else we should know about your child?
Do you have particular expectations of our program regarding your child's development?
Eating
What is your child's general attitude towards eating? *
Does your child have any food allergies? *
Can your child feed himself/herself? *
Sleeping Habits
What time does your child go to bed at night? *
Time
:
Does your child have his/her/ own room? *
Does your child have any special habits at bedtime (such as sleeping with a blanket or stuffed animal, etc.)? *
Does your child take naps? *
If so, how long are his/her naps? *
Does your child have a bottle at night or naptime? *
Does your child wear diapers to bed at naptime or at night? *
Can your child be relied upon to indicate his/her bathroom wishes? *
Does your child need to go more frequently than usual for his/her age? *
What word is used for urination? What word do you use for bowel movements? *
If trained, does he/she have accidents? *
Does your child wet the bed at night? How frequently? *
We are pleased to be able to share in this important developmental period in your child's life. What means of sharing information is most convenient for your? Do you prefer phone calls, individual conferences, evening or daytime meetings, emails? *
Please add any additional information that you believe was not included.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy