Parent's Questionnaire

Section 2: Medical History

Your impressions and opinions of your child's abilities and comparative difficulties are very important in a complete assessment of your child. Could you please complete this questionnaire adding additional comments as necessary. If you do not know the answer to a question or it is irrelevant to your child, feel free to leave the question blank. Press submit at the bottom of the page when completed. Your assistance is appreciated and this information will be treated as confidential at all times.

Section 3 Developmental milestones and abilities

Please indicate the approximate age at which your child:
For the next three questions, using the one word classifications (answers) of 'Advanced', 'Normal' or 'Slow' what is your general impression of your child's motor development?

General behaviour:

Using the one word classifications (answers) of 'Never', 'Sometimes', 'Usually', Always' or 'Unsure' what is your general impression of your child's general behaviour?

Section 4 sensory:

Using the one word classifications (answers) of 'Never', 'Sometimes', 'Usually', Always' or 'Unsure' what is your general impression of your child's sensory behaviour?

Section 5: concerns

Using one word classifications (answers) of 'Yes', 'No' or 'Unsure' please indicate areas of concern for your child:

Section 6: summary

Thank you very much for your time and effort. Please click the submit button.