Nick Name _________________________ Brother’s Name _____________________ Sister’s Name _______________________ My cute My Fav. Color(s): ____________________ Photo My Fav. Toy(s): ______________________ My Fav. Book (s): ____________________ My Fav. Food (s): ____________________
How would you describe your child’s personality?
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Does your child have a regular bedtime schedule ( ) yes ( ) no
What time does your child usually go to bed at night? ________ What time does your child usually wake up in the morning? _______ Does your child have trouble sleeping? _____ Night Terrors? ______ Trouble going to sleep? _______ Other: _________________________________________________ What time(s) and for how long does your child usually nap? ________ Are there any special dolls, blankets, etc. that your child needs to go to sleep? _____________________________
Does your child has any known health problems? ( ) yes ( ) no
If yes, describe: ___________________________________________ Does your child have any known allergies? ( ) yes ( )no If yes, please list allergies: ____________________________________ Special instructions in case of an allergic reaction: _____________________________________________________