Parent Information – Daycare Center

Information and Instructions for filling out this form.

Tell Us About Your Child

Name of Child(Required)

First Last

Nickname

First

Siblings and ages

Special Attachments(Required)

i.e. blanket, teddy bear, etc.

Likes(Required)

Dislikes(Required)

Toileting Names

First

Habits

Particular Fears

How is your Child's anger expressed?

How do you discipline your child?

Has your child ever been separated from you? How did they handle it?

Has your child ever been hospitalized?

Child's Strengths, in your opinion?

Any Additional information about your child:

What can we do for you and your child to help in this transition?

Parent Signature(Required)

First Last

Parent Email(Required)

Signature

Date

Phone

This field is for validation purposes and should be left unchanged.