Parents' Assessment Questionnaire - Early Years 

Dear parents,

The primary purpose of this questionnaire is to ensure the best possible start for your child at PBIS Early Years Unit (EYU).

Which Campus will your child attend? *
Name of child *
Current age (in years) *
Date of birth *


Gender *
Name of parent/carer *
Relationship to child *
Nationality
Does your child currently attend Nursery, Preschool or Day Care, or have they attended in the past? *
If YES, please provide details below of the length of time your child attends/has attended Nursery/Preschool/Day Care, including the daily duration and number of times each week. For example: My child has attended Preschool for 6 months, she/he attends for 4 hours, two days a week. *
Previous school name and contact: *
Is your child’s first language English? *
If YES, please specify names and ages of siblings and school/s attended:
If NO, please give examples of when your child has the opportunity to use spoken English and describe their level and understanding of English: *
Does your child have siblings? *

Do siblings speak fluent English or attend an English speaking school *
Please list any other languages your child speaks, and their proficiency. *
Is your child able to communicate their wants and needs effectively? e.g.: can they tell you when they want something, if they are hungry or if they are tired? *

Please describe the level of self-care your child demonstrates in the following areas:

How does s/he get on when meeting new people? *
Can they ask to go to toilet and use it independently?
*
Can they wash their hands independently? *
Are they mainly dry throughout the day? *
Do they wear nappies? *
Are they able to dress themselves independently? *
Does he/she eat independently? *
In our school children are expected to take part in all lessons with regular attendance. We will be spending a lot of time outdoors in variable weather conditions throughout the year and going on trips and weekly forest school activities. Do you foresee any reason why your child will not be able to participate in the above activities or attend regularly? *
If YES, please give further information: *
Does your child have regular play dates with friends? *
How does s/he get on when meeting new people? *
Please describe your child´s personality. *


What is your child’s favourite …

book? *
song? *
activity? *
toy? *
Who is their best friend? *

Other information

Does your child normally nap during the day? *
Any allergies or medical concerns we need to know. *
Who will collect your child from school? *
What rewards and sanctions do you use at home? *
Any other information? *
I confirm that all the information given on this form is accurate. *



Please leave the next box blank or your submission will not be accepted: