Getting to Know Your Family

Thank you for taking the time to share about your family. These questions aren’t meant to assess or judge your family, but to give me a clearer picture of your family’s rhythms, your child’s strengths, and the areas where extra support might be helpful. Please answer only what feels comfortable, your perspective is what matters most.

Your first and last name

Your child's first name

About your child

What are some things your child enjoys or feels proud of?

What usually makes your child feel calm, safe, or at ease?

What tends to make things harder for your child (environments, demands, changes, social interactions, etc.)?

When your child is upset, how do they usually show it?

How does your child like to communicate their needs (words, gestures, behaviors, withdrawal, other)?

Daily Life & Routines

What parts of the day go most smoothly for your child and family?

What times of day or transitions feel more challenging?

What routines or supports are already in place that help your child manage daily life?

Are there places or activities outside of home where your child thrives?

Family Dynamics

How does your child connect with parents, siblings, or other close family members?

What are some activities your family enjoys doing together?

Are there moments of conflict, stress, or worry that come up often in family interactions? Please share what you are comfortable with.

How do you and your co-parent (if applicable) approach challenges differently or similarly?

Parenting Perspectives

What are your biggest hopes for your child right now?

What do you feel most confident about in your parenting?

What feels most draining, confusing, or overwhelming at the moment?

Support and Goals

Have you worked with other professionals (therapists, teachers, coaches)? If so, what felt helpful or unhelpful?

What changes would you love to see in your family life?

If there’s anything more you’d like to add or highlight, please feel free to share it here.