2/3 Year Old Class Questionnaire
Parent's Name
Parent's Email
Child's Name
Date of Birth
/
Month
/
Day
Year
Date
Daily Routines
Is your child potty trained?
Yes
No
In Progress
Does your child nap during the day?
Yes
No
If yes, what time does your child usually nap?
Hour Minutes
AM
PM
AM/PM Option
Does your child have any allergies, dietary needs or restrictions?
Yes (please fill in below)
No
Please list any allergies, dietary needs or restrictions, if applicable
Social and Emotional
How does your child typically respond to separating from you or other caregivers?
Easily transitions
Sometimes needs comfort/reassurance
Often struggles with separation
Has your child had any experience in group settings (playgroups, daycare, classes)
Yes
No
Does your child show any strong fears or sensitivities (e.g., loud noises, crowds, certain textures)?
Yes (please explain below)
No
Please explain if you answered "yes" to the previous question.
Learning and Behavior
Does your child have any unique learning, sensory or behavioral needs?
Yes (please describe below)
No
Unsure
Please explain if you answered "yes" to the previous question. Even if your child has not had a formal observation, any observations you share will help us support them.
What helps your child calm down if they are upset?
What are your childs favorite activities or toys?
Are there any family traditions cultural celebrations or languages spoken at home we should know about?
Is there anything else youd like us to know about your child or your hopes for their experience?
Submit
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