Intake Meeting Form

Child’s Name: ______________________ Date: _____________

Family Member (s) attended: ___________________________________________

What name would you like us to call your child?

Tell me about your child and your family.

What goals do you have for your child this year?

Do you have any particular questions or concerns that you would like to discuss?

Summary of discussion about enrollment forms, transitioning into care, goals for the
classroom etc.

Here you document whatever else is discuss in conference to share the information with
your team. This could be about question you asked about enrollment forms such as
allergies, curriculum you said the classroom would work on