Psychology Testing Intake Form

  • The First Few Months of Life

  • Milestones: At What Age Did Your Child Do Each of These?

  • Sat without support:Crawled:Walked without holding on:
  • Helped when being dressed:Tied shoelaces:Buttoned buttons:
  • Ate with a fork:Stayed dry all day:Didn’t soil his or her pants:
  • Speech/Language Development

  • Child Characteristics

  • Special Skills or Talents of Child