Fillable Family Interview Form (Page 5 of 6) in pdf

Family Interview Form Page 5

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6. What are the routines for quiet time, bedtime and naps? When is bedtime? Do your children

have a favorite bedtime story? Do they like a light on? Do you prefer their door open or closed?

Do they sleep with particular blankets or stuff ed animals?

7. What do you want your children to wear for outdoor play? For naptime? For bedtime?

8. Where do I put dirty clothing?

9. Would you please show me any special equipment I might be using to take care of the

children?

10. Are there any medical conditions or medications that I should be aware of? If the child

is taking medication, where is it kept? Would you please fi ll out this Parental Consent

and Contact Form? Does your child have an AAP Emergency Information Form for

Children With Special Health Care Needs? Would you provide a copy that I can give to

EMS and/or hospital personnel in case of an emergency? Are there special instructions

or precautions I should be aware of?

Not e: If the parents do not fi ll out the Parental Consent and Contact Form you should

not give the children any medications.

11. Do your children have any other specifi c care needs or routines that I should know

about (e.g., tutoring, music or sports practice, faith practices)?

12. Do your pets need any special care?

13. Is there anything else I need to be aware of?

FA M I LY I N T E R V I E W F O R M

Family Interview Form Page 5

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