Student Profile: Parent Form

Child’s Name____________________________Date of Birth_____________________

School_____________________________Phone__________________________

Grade Level_________________________Date Completed__________________

1. What my child is interested in:
   
2. Things my child is ready to learn:
   
3. My child is best at:
   
4. My child needs most help with:
   
5. Help my child has received in the past:
   
6. Problems with my child’s current program:
   
7. Possible alternatives and/or additions to my child’s current program:
   
8. Services that my child needs:
   
9. Special concerns I have about my child:
   
10. Suggestions I have about working with my child:
    
11. Strengths my child has in the area of:
    • Academics:
      
    • Speech:
      
    • Motor:
      
    • Social/Behavior:
      
    • Vocational/Prevocational:
      
    • Self-Help:
      
    • Self-Advocacy Skills:
      
12. Concerns I have for my child in the following areas:
    • Academics:
      
    • Speech:
      
    • Motor:
      
    • Social/Behavior:
      
    • Vocational/Prevocational:
      
    • Self-Help:
      
    • Self-Advocacy Skills:
      
13. When my child leaves high school as a young adult, I expect: