Get the free Child Intake Form (1) (1) - Child & Teen Psychologist - drjennie
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IDENTIFYING INFORMATION Child's Name: Date of birth: Age: Grade: Race/Ethnicity: Religious affiliation: Person completing this form: Today's date: How did you hear of Dr. Jennie? Child's custodian/guardian(s)
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What is child intake form 1?
Child intake form 1 is a form used to collect information about a child who is entering a childcare program.
Who is required to file child intake form 1?
Parents or guardians of the child are required to file child intake form 1.
How to fill out child intake form 1?
Child intake form 1 can be filled out by providing information such as the child's name, date of birth, medical history, and emergency contacts.
What is the purpose of child intake form 1?
The purpose of child intake form 1 is to ensure the safety and well-being of the child while in the care of the childcare program.
What information must be reported on child intake form 1?
Information such as the child's name, date of birth, medical history, and emergency contacts must be reported on child intake form 1.
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