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Treetop Village Family Questionnaire

1.What is your child's first name?
2.What are three words that describe your child? 
3.What are your child's strengths? 
4.What are your child's challenges?
5.What are your families' strengths?
6.Has your child been extremely sick or hospitalized since birth?
7.Has there been any major changes in child's life in past 24 months?  Move, divorce, trauma, sibling born, etc?
8.Does your child have any behavior concerns?  Aggression, biting, yelling, etc? Have they been diagnosed with ADHD, Autism, etc? Do they have an IEP?
9.Is your child on any type of medication?
10.Who does child primarily live with?
11.Parents separated or divorced?
12.What is child's home routine like?
Wake up time?
Eat dinner together? 
Bed time?
13.Do you have any concerns for your child?
14.What type of discipline do you use at home? Loss of electronics, spanking, time-outs?
15.Does your child get more than one hour of screen time daily? 
Cell phones, TV, tablets? Is it supervised? What kind of screen time does child enjoy? Video games, learning apps, movies, etc?
16.What does your child eat at home? 
Breakfast?
Lunch?
Dinner?
Snacks?
17.Does your child eat food with dyes in it? 
Are you familiar about food dyes and behavior and health concerns?
18.Do you eat dinner as a family?
19.What activities does your child do at home?
20.What activities does your family do together?
Park, bike riding, TV time, camping, etc?
21.Is your child in extra curricular activities like soccer, dance, etc?
22.Has your child been in previous daycares?
How was your experience? Why did you leave? 
23.What are your goals for your child while at Treetop Village?
24.Do you need resources for parenting at home?
25.Do you need help with basic needs? Food, housing, clothing?
Current Progress,
0 of 25 answered