Tell Us About Your Baby – English

Child's Name(Required)

First Last

Birthdate(Required)

MM slash DD slash YYYY

Reminder: All items must be labeled with Child's full name. (Includes bottles, breastmilk bags, clothing, pacifiers, etc)

Approximate drop off time(Required)

Approximate pick up time(Required)

Please describe any allergies ex. seasonal, skin or any intolerances

***Medication chart must be completed daily***

How is your baby fed?(Required)

Breast Milk

Formula

How many ounces of breast milk?

How many ounces of formula?

What kind? (Brand name and type: ex. Similac Soy)

How often is your baby fed?(Required)

Eats/Fed on demand

A schedule

How many hours between each feeding?

How do you put your baby to sleep? (choose all that apply)(Required)

Rocking

Walking

Music/Sound Machine

Patting

Pacifier

Swaddle (please provide)

Reminder: No blankets are allowed in the baby's crib

Is there anything else we should know in caring for your baby?

Parent Comments at update

Initials(Required)

Date of enrollment(Required)

MM slash DD slash YYYY

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