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Get CA LIC 702 2008

DOCTOR’S CARE? ■ YES ■ YES ■ DOES CHILD TAKE PRESCRIBED MEDICATION(S)? ■ NO DOES CHILD USE ANY SPECIAL DEVICE(S): ■ IF YES, NAME OF DOCTOR: IF YES, WHAT KIND: NO YES ■ IF YES, WHAT KIND AND ANY SIDE EFFECTS: NO DOES CHILD USE ANY SPECIAL DEVICE(S) AT HOME? IF YES, WHAT KIND: ■ YES ■ NO PARENT’S EVALUATION OF CHILD’S PERSONALITY HOW DOES CHILD GET ALONG WITH PARENTS, BROTHERS, SISTERS AND OTHER CHILDREN? HAS THE CHILD HAD GROUP PLAY EXPERIENCES? DOE.

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