Eating Habits. The Owner understands that environmental stress may alter a dog’s eating habits. A dog may vary in food intake while with the Company, and adjust to the changes when returning to the Owner.
Eating Habits. At what time does your child eat breakfast? Lunch? Dinner? Between meal snacks? Does your child feed himself/herself? Food Favorites: Food Dislikes: Food Allergies: What foods does your child eat at home? Optional Sleep Habits: Does your child have his/her own room? Shares room with: (other children, parents) At night sleeps from to Average hours of sleep per night: Does your child sleep through the night? Naps from to Average Hours of Naps: ToiletHabits: Can your child use the bathroom independently? Does your child tell you when he/she needs to go? What words does your child use for urinating and bowel movements? If you have further questions please call the Preschool Programs office at GSRP MSDS Information for a Child Student Name (as written on birth certificate): Program (circle one): GSRPSchoolDay HeadStartBlend GSRPHalf-Day GSRPExtendedProgram Bussing(circleone): Yes No Teacher/Building: / Federal Poverty Level Quintile (Select One based income documentation): ❑1stQuintile:0–50% ❑2ndQuintile:51–100% ❑3rdQuintile:101–150% ❑4thQuintile:151–200% ❑5thQuintile:201–250% ❑251–300% ❑301%andAbove CODE01inMSDS CODE02inMSDS CODE03inMSDS CODE04inMSDS CODE05inMSDS CODE06inMSDS CODE07inMSDS Additional Eligibility Factors (check all that apply): o o o o o o 02–Diagnoseddisabilityoridentifieddevelopmentaldelay 03–Severeorchallengingbehavior 04–PrimaryhomelanguageotherthanEnglish 05–Parent/guardianwithloweducationalattainment 06–Abuse/neglectofthechildorparent o 07–Environmentalrisk 08–None Qualification Factor (check all that apply): ◇ ◇ ◇ ◇ A - Homeless B - Xxxxxx Care C - Qualifying IEP D - None
Eating Habits. 1. I eat a variety of foods each day, such as fruit Alcohol and Drugs Score: ~-------- and vegetables, whole grain breads and cereals, lean meats, dairy products, dry peas and beans, and nuts and seeds.
Eating Habits. Is your child (check all applicable): Able to Feed Self: Slow Eater: Fast Eater: Any Food Allergies? (circle one): No Yes If yes, what? My child’s appetite is … (circle one): Good Appetite Poor Appetite My child enjoys the following food(s):
