Preschool Questionnaire

This student questionnaire serves as an invaluable resource for your child’s teachers to assist them in understanding how best to meet your child’s needs in the classroom before they start their time in preschool.

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Child's Name (First & Last) & Gender *
Child's Date of Birth *
Parent Completing Form (First & Last Name) *
Parent Email *
Section 1: General Information
What does your child prefer to be called? *
1 point
Names & ages of siblings or other non-guardians living in the household *
1 point
Are there any pets in the household? If so, please list. *
Has your child been in a child care/preschool setting prior to enrollment this year? *
Section 2: Health
Has your child had a previous serious illness, injury, or hospitalization during the past 12 months? *
Does your child choke easily while eating? *
Is your child able to feed him/herself with utensils or fingers? *
Does your child have any special needs, or have you noticed any developmental delays (physical, emotional, or social)? Please explain. *
Does your child receive any special services (speech therapy, occupational therapy, etc)? If yes, please explain.  *
Section 3: Toileting
Does your child need assistance with toileting? *
How can we best help?
Does your child have any fears or aversions in regard to toileting (i.e. fears flushing sounds, etc)? If so, please explain. *
Section 4: Behavior
Does your child have any special fears or dislikes (i.e. loud noises, certain textures, etc.)? If so, please explain. *
How does your child communicate his/her needs? *
Are there any special words your child uses that might not be readily recognized by others? *
How is your child normally comforted? *
How does your child normally express anger or frustration? *
How do you tell your child to stop a behavior that you don't approve of or that might be dangerous? *
When your child gets upset, what will help calm him/her down? *
What is a good way to distract your child when he/she is having a temper tantrum? *
Section 5: Habits & Activities
Does your child nap? *
What are your child's favorite toys and playtime activities? *
Does your child prefer to play on his/her own as opposed to with peers? *
Is there anything else you would like us to know about your child (i.e. particular personality traits, quirks, etc.)? *
Section 6: Family
Have there been (or do you anticipate) any changes in your household - i.e. new baby, new job, new house, recent loss, etc.? If so, please explain. *
Please tell us a little about your family - parent's jobs, extended family out of state, not a TX native, etc. *
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