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DATE
CHILD’S FULL NAME*
NICKNAME/ABBREVIATION
DATE OF BIRTH
DATE OF COMMENCEMENT
DAYS OF ATTENDANCE
MONTUESWEDTHURFRI
I HAVE PREVIOUSLY ATTENDED AN EARLY CHILDHOOD SERVICE
YESNO
CURRENT FAVOURITE TOYS / GAMES / TYPES OF PLAY
CURRENT FAVOURITE MUSIC / SONGS
CURRENT FAVOURITE BOOK
AT HOME I LIVE WITH OTHER SPECIAL PEOPLE I HAVE A CONNECTION WITH FAMILY PETS MY HOME LANGUAGE MY CULTURAL BACKGROUND CULTURAL TRADITIONS AND FAMILY CELEBRATIONS I AM CURRENTLY CONNECTED WITH AN ALLIED HEALTH PROFESSIONAL (E.G., SPEECH PATHOLOGIST) YESNO [group health-prof-selected] IF YES, PLEASE PROVIDE FURTHER DETAILS [/group]
I HAVE A FOOD ALLERGY/ INTOLERANCE / DIETARY REQUIREMENT
[group eating-habits-selected] IF YES, PLEASE PROVIDE FURTHER DETAILS [/group] I HAVE PROVIDED A COPY OF MY CHILD’S ALLERGY OR MEDICAL ACTION PLAN FROM A DOCTOR
FOODS I ENJOY EATING FOODS I DISLIKE
I AM:
CONFIDENT USING THE TOILETNEED SUPPORT USING THE TOILETUSING NAPPIES / PULL-UPS
DURING THE DAY, I:
SleepRest
TIME OF DAY: LENGTH OF SLEEP: MY SLEEP / REST PREFERENCES INCLUDE:
DEVELOPMENTAL SKILLS I AM CURRENTLY PRACTISING LEARNING GOALS FOR THIS YEAR
