Waiting List | smilingfaceshomedaycare.com

Because of your smile, you make life more beautiful.
Thich Nhat Hanh

Child's Name *

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Last

Parent's / Guardian's Name *

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Last

Phone

Email *

Date Needing Service

Services Needed - Check All that Apply *

Thank you for choosing Smiling Faces Home Day Care!

By answering the questions below, you will be providing me vital information that will help me better serve your needs for your child.

Does your child have siblings?

If Yes, please list the siblings' Name and Age.

Has your child been in other care before?

If Yes, where?

What is your child’s primary language?

Does your child have food dislikes or allergies?

Does your child nap?

Please describe the napping time(s) and how long.

How would you describe your child’s personality? Any fears?

What would you like me to know about your child?

What development skills do you want your child to gain?