CHILD'S SCHEDULE AND INTERESTS
The following information on your child's routines and activities will help the provider give your child the best possible care.  If a question does not apply, please leave it blank.

EATING

Food Likes/Dislikes:

Food Allergies:

Comments:

SLEEPING

Napping Schedule:

Comments:

BATHROOM

Is Your Child Potty Trained?

Toilet Training Routine/Methods:

Comments:

ALLERGIES

Does your child have any known allergies?

If YES, please list:

Comments:

PLAY

Favorite activites:

Favorite toys:

Does your child play well with other children?

Comments:

FEARS

Does your child have any fears?

Please describe:

Comments:

DISCIPLINE

Please describe the steps you take in the discipline of your child at home:

Comments:

SPECIAL NEEDS

Please describe any medical, physical, or emotional needs your child may have that may require special attention to:

Comments:


Add any information about your child which you feel would help the provider to give the best possible care for your child:







Please describe your child's typical day:
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