Center for Cognitive Development - developmental questionnaire for parents
Dear parents,
Thank you for your interest to participate in studies with the Center for Cognitive Development at Tel Aviv University!
We appreciate it if you could share with us some developmental information regarding your child(ren) and answer the questions in this form.
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Please fill in your preferred method of contact for notifications about relevant studies (phone no., email, etc.): *
Your full name:
Your highest level of completed education
Other parent's name:
The other parent's highest level of completed education
How would you estimate your household income compare to the general population in Israel?
Clear selection
City or area of residence
Your child's full name:
Your child's sex:
Clear selection
Your child's date of birth: *
MM
/
DD
/
YYYY
At what week of pregnancy was your child born?
Were there any complications during your child's birth? If so, please elaborate.
Was your child diagnosed with any neurological or developmental disorder? If so, please elaborate.
Would you like to register another child for the Center for Cognitive Development? *
How did you hear about the TAU Center for Cognitive Development?
Is there any other information you would like to add?
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