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Getting to Know Your Child (Toddler)
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Email
*
Your email
Child's Name
Your answer
Child's Date of Birth
MM
/
DD
/
YYYY
Does your child go by any other name than their given name?
Your answer
Has your child been previously enrolled in daycare or preschool? If so, what was your reason for leaving?
Your answer
Do you anticipate any difficult times for your child at school?
Your answer
Please list all people living in your household ( list age of siblings).
Your answer
Please list adults and their relationships outside of the home that are directly involved in your child's life.
Your answer
Does your child have any fears or anxious feelings that we should know about? (i.e., fear of animals, loud noises)
Your answer
Does your child have any known allergies?
Your answer
Has your child ever been stung by a bee or wasp? If so, what was the physical reaction?
Your answer
Does your child nap? If so, at what time and for how long?
Your answer
Does your child use a comfort item for sleep or nap?
Your answer
Does your child sleep in a bed or crib at home?
Your answer
Does your child take a bottle or pacifier?
Your answer
Who will be bringing your child to school? Will this person be likely to have difficulty separating from the child?
Your answer
Is your child potty trained?
Yes
No
Other:
Does your child need reminders to use the bathroom?
Yes
No
Other:
Does your son stand or sit to urinate?
Your answer
Does your child eat independently?
Yes
No
Other:
Does your child use utensils to feed self?
Yes
No
Other:
Does your child sit at a table or in a high chair at home?
Your answer
Was your pregnancy full term or pre-mature?
Your answer
Were there any complications with your pregnancy or birth?
Your answer
Is there anything else you'd like us to know?
Your answer
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