EYFS Food Survey Nursery Food Questionnaire This questionnaire is only for parents of children in our nursery, Owlets. All other children then please ignore. Please answer all questions on this form and don't forget to submit at the very end! Please enable JavaScript in your browser to complete this form. Please enable JavaScript in your browser to complete this form. cup? high would Name of child * First Last Child's Date of Birth: Does your child have any allergies, if so please explain. In none, please type 'none' * Any specific dietary requirments - please explain? Does your child sit at the table to eat? * Yes No Does your child use a high chair or other booster seat? Yes No Does your child eat their meal with others? Yes No Is your child eating at set meal times? Yes No Is your child able to eat independently? Yes No Does your child need distraction to eat?rw Yes No Can your child use cutlery? * Yes No Does your child use an open cup? * Yes No Is your child able to cut up food independently? Yes No If not is your child: eating cut up meals?/ eating mashed up or pureed food? * Yes No Are there any textures or foods that your child dislikes or finds difficult to eat? * Has your child ever had an episode of choking? * Yes No Has your child ever been referred for nutrition, eating habits or other dietary advice? * Yes No Is there any aspect of your child’s eating that you would like further guidance or support with? * Is there anything else you would like us to know about your child and their diet and eating? Please sign the form to confirm that the information you have provided is true and accurate to the best of your knowledge. Clear Signature Submit
