• PARENT QUESTIONNAIRE

  • Dear Parents,

    Please help us get to know your child by filling out this form. All the information will be confidential. We will use what you tell us as we begin to get to know your child and plan ways to meet his/her needs and to help him/her develop. Please return it to school as soon as possible.

    Thanks so much!

  • Date Format: MM slash DD slash YYYY
  • It is our goal to encourage a sense of belongingness, promote an appreciation of others and enrich children’s experiences by integrating into our curriculum activities and information that reflect our individual children’s background.  One way we can do this is by learning about each child’s family background, celebrated holidays, and traditions. Please take a few minutes to share with us your special family days or activities and how they are carried out in your home.

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • All children develop at different rates and in different ways. Please do not worry if your child is not doing all or any of the activities mentioned in the questionnaire. It is not a test. The activities are simply one way of understanding how your child is progressing

    Possible answers:

    Yes = your child does this activity (or has done it and has now progressed, e.g., crawling, but is now walking)

    Sometimes = your child is just beginning to do this activity (but does not do it regularly)

    Not Yet = your child has not yet started doing this.

    Please leave blank any activities your child has not been able to try with you

  • Important Points to Remember:

    • Try each activity with your child before marking a response.
    • Make completing this questionnaire a game that is fun for you and your child.
    • Make sure your child is not tired or hungry.
    • Please bring this questionnaire with you to your child’s health and development review.
    • Communication

    • GROSS MOTOR

    • FINE MOTOR

    • PROBLEM SOLVING

    • PERSONAL-SOCIAL

    • OVERALL

      Parents and providers may use the space below for additional comments.