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Dr. Raymond F. Castellino 1105 N. Ontare Rd. Santa Barbara CA 93105 Ph 805 687-2897 Fax 805 687-4719 PARENT INTAKE FORM Today s Date Name Licenses and degrees Birth date Age Height Weight Who referred you to us Profession or past profession s for full time moms What is your intention for doing family session s with Ray Some of the session activities involve physical exertion. Do you have any medical conditions that would contraindicate involvement in any activity Yes No If yes please explain...

How to fill out parent intake form

How to fill out parent intake form:

1. Start by reading the instructions provided on the form carefully. Make sure you understand what information is required and how it should be filled out.
2. Begin by providing your personal details, such as your full name, contact information, and relationship to the child.
3. Fill out the sections that require information about the child, including their full name, date of birth, and any relevant medical or educational history.
4. Some forms may ask for specific details regarding the child's allergies, medications, dietary restrictions, or behavioral issues. Ensure you provide accurate and complete information in these sections.
5. If the form includes a section for emergency contacts, make sure to include the names and contact details of individuals who can be reached in case of an emergency.
6. If there are any areas on the form that you are unsure about or do not have the necessary information for, leave them blank or indicate that the information is not available.
7. Review the completed form thoroughly to check for any errors or missing information. Make sure all sections have been filled out properly before submitting the form.

Who needs parent intake form:

1. Parent intake forms are typically needed by various organizations that work with children, such as schools, childcare centers, summer camps, and extracurricular activity providers.
2. These forms help these organizations gather important information about the child and their family, ensuring they can provide appropriate care and support.
3. By collecting details about a child's medical history, allergies, and emergency contacts, these forms help create a safe and secure environment for the child.
4. The information provided in parent intake forms allows organizations to better understand and meet the individual needs of each child, ensuring a positive and personalized experience for them.

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What is parent intake form?

The parent intake form is a document that collects information about a child's family, background, and needs.

Who is required to file parent intake form?

Parents or legal guardians are required to file the parent intake form.

How to fill out parent intake form?

The parent intake form can be filled out online or in person by providing accurate information about the child and family.

What is the purpose of parent intake form?

The purpose of the parent intake form is to assess the needs of the child and family in order to determine appropriate services and support.

What information must be reported on parent intake form?

Information such as family background, medical history, living situation, and any special needs or concerns must be reported on the parent intake form.