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Navigation Menu
Navigation Menu
Home
About BJE
Educators
Leadership
Join BJE-ECC
Parent Ambassador Program
Our Programs
Northbrook
Wilmette
Camp BJE
Contact BJE
Events
Create an account
Log-in
My account
JUF Right Start
Forms
Enroll your child
Getting to know your infant/toddler
RM_Stats
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Email
*
Username
*
Password
*
Password must be at least 7 characters long.
Enter password again
*
Password must be at least 7 characters long.
Your first name
Your last name
Have you registered more than 1 child?
No
Yes
For which child is this form?
Select an option
1
2
3
Child's first name
Child's last name
Child's birthday
Child's first name
Child's last name
Child's birthday
Child's first name
Child's last name
Child's birthday
Is your child
*
breast-fed?
bottle-fed?
Both bottle-fed and breast-fed?
When do you use bottle vs breast?
What position does your child like to be in while being burped?
What position does your child like to be in while bottle feeding?
How do you give bottle:
Room temp
Cold
Warm
Does your child hold their own bottle?
Yes
No
Is your child on
milk?
formula?
What kind of milk?
What kind of formula?
Does your child eat
baby cereal?
strained or other baby foods?
What kind of cereal?
List the varieties you use (fruits, veggies, etc)
Food likes?
Food dislikes?
List the amount/variety of food and times your child usually eats breakfast
List the amount/variety of food and times your child usually eats lunch
List the amount/variety of food and times your child usually eats dinner
Does your child have any food sensitivities?
Yes
No
What are they?
Will your child be fed before arriving?
Yes
No
Will your child have a special comfort item to sleep with?
Yes
No
What is it?
Does your child sleep through the night?
Yes
Sometimes
No
How often do they wake?
How do you want us to put them down to sleep?
What time does your child wake in the morning?
How do they wake up?
On their own
They are wakened
What time does your child wake in the morning?
What time does your child wake in the afternoon?
Does your child usually cry when going to sleep?
Yes
No
For how long?
What type of diapers does your child use?
Describe your child's diapering routine (liners, creams, powders, etc)?
Is your child prone to diaper rash?
Yes
No
How do you treat diaper rash?
Please share a bit about your child's developmental progress - when did your child crawl, sit alone, walk, say their first words and repeat short sentences (if applicable)?
Please share with us any specific information regarding the way in which your child entered/joined your family (Adoption, surrogacy, delivery experiences, prematurity, foster care, etc), as well as birth weight and any complications we need to be aware of
Is your child aware of their way of joining your family?
Yes
No
Please tell us more about this
Does your child have any known allergies?
No
Yes
How does the allergy manifest itself?
What are they?
Describe the treatment for the allergic reaction
Is your child on medication?
No
Yes
What is it and when is it given?
Does your child receive support services (speech therapy, physical therapy, occupational therapy, etc)?
No
Yes
What are the services, and from what agency?
Does your child:
Have frequent colds?
Have frequent tonsilitis?
Have frequent earaches?
Have frequent stomachaches?
Run a high fever easily?
Vomit easily?
Has your child had any serious injuries?
No
Yes
Please share details
Please give a statement of your child's overall health. Please include any dates for surgeries, hospital stays, etc
Please describe your child's strengths and weaknesses, your attitude toward parenting and any other comments which would be helpful in getting to know you and your child better?
Please confirm that this form is complete
Confirmed
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