Student Name: _________________________________________________
Student Birthday: _______________________________________________
Parent/Guardian Name(s): _________________________________________
What is the best way for me to contact you?
____ Phone ____ Email
Phone Number: _________________________________________________
Email Address: _________________________________________________
What are your child’s interests/hobbies?
Is there anything you would like me to know about your child?
This questionnaire is to help me get to know your child a little better. The information provided will be kept confidential. Parent-teacher communication is important to me, and I believe it will be beneficial to your child as well. Thank you for your support!Jeanne Bartley, M.A., CCC-SLPSpeech-Langauge Pathologistjbartley@frsd.k12.nj.us(908) 284-7650