Instructions:

To help us best evaluate your child’s feeding needs, please record EVERYTHING your child eats and drinks for 3 days along with in and the TIME your child ate or drank each item. Please complete and submit within 2 weeks of your child's evaluation.

Please include the EXACT description of the item entered and your best guess of the portion size/amount eaten. Write the brand name of formula and juice and any special recipes for drink mixtures your child uses (i.e., 24 calorie Isomil + 1 Tsp. Polycose). Add any additions to foods (e.g.,  ¼ cup mashed potatoes + 1 Tbsp. of margarine). Be sure to include dressings, sauces, gravies, and anything extra.

IMPORTANT: Please use measuring spoons and cups when serving your child for these 3 days if it will help you to report more accurately.