Has student been in any special program?
If Yes, specify
If student’s records from previous schools not available, please give full name and address of last school where records can be obtained.
Does your child have any health condition(s) that school personnel should know about?
If Yes, explain
Were there any complications in the pre-natal, delivery, or post-natal periods?
If Yes, explane
Are there any present or past sleeping or eating problems?