Saint Michael Academy

 

GET-ACQUAINTED INFORMATION

 

PLEASE PRINT                                                                                     Date: _________________

 

Parent/Guardian’s Name:  ____________________________________ Child’s Name:  _____________________

 

1.       Does your child have a pet? _________  If so, what? ___________________________________________

 

2.       How many hours a day does your child watch TV? _________________  What programs does he/she view?

 

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3.       What is the usual bedtime hour? ___________________

 

4.       Does your child have any habits such as thumb sucking, nail biting or others? ________________________

 

Please describe:  _________________________________________________________________________

 

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5.       Does your child have any particular fears or nightmares? _________________________________________

 

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6.       What is your usual method of reassuring and rewarding your child?  ________________________________

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7.       What is your “Philosophy” of disciplining your child?  ___________________________________________

 

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8.       Does your child have allergies? ______________________________________________________________

 

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9.       Is your child under any medication or therapy? __________________________________________________

 

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10.   Have there been any major changes in the family, such as separation, divorce, death illness or moving?

 

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11.   Previous Day Care/School Attendance?  Name: _________________________________________________

 

Please list anything else about your child of which you think we should be aware: _________________________

 

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