New Nursery Parents – Enrolment Forms

Food Questionnaire:

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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? *

or referred been

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.

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Please take a few minutes to answer our Owlets Food Questionnaire, an essential part of our onboarding paperwork for new parents to Owlets. Please answer as accurately as you can.