Cookie settings

We use some essential cookies to make this website work. We’d like to set additional cookies to understand how you use wchc.nhs.uk, remember your settings and improve our services. We also use cookies set by other sites to help us deliver content from their services.

View cookies

You have accepted additional cookies. You can change your cookie settings at any time.

You have rejected additional cookies. You can change your cookie settings at any time.

Skip to main content

About us
News
Resources
Feedback
Children and Young People
Professionals

Enter your search term

Enter your search term

Home
Work with us
Services
Locations
Your health and care

Home
Work with us
Services
Locations
Your health and care

Home
Work with us
Services
Locations
Your health and care

About us
News
Resources
Feedback
Children and Young People
Professionals

Home - Our services - School Nursing (Knowsley) - Foundation Stage 2 Child Health and Development review (Knowsley)

Foundation Stage 2 Child Health and Development review (Knowsley)

Step 1 of 3

33%

Registered School*
Other school name*
About Parent/Carer
Your Name*
Relationship to child*
Child's name*
Child's Date of Birth*

Day
Month
Year
Address Line 1*
Address Line 2*
Town or City*
Post Code*
Telephone Number*
Email

Other members of the household
Household member 1
Member 1 Name
Member 1 Date of Birth

Day
Month
Year
Member 1 Relationship to child
Household member 2
Member 2 Name
Member 2 Date of Birth

Day
Month
Year
Member 2 Relationship to child
Household member 3
Member 3 Name
Member 3 Date of Birth

Day
Month
Year
Member 3 Relationship to child
Add Household Member 4
- Add
Household member 4
Member 4 Name
Member 4 Date of Birth

Day
Month
Year
Member 4 Relationship to child
Add Household Member 5
- Add
Household member 5
Member 5 Name
Member 5 Date of Birth

Day
Month
Year
Member 5 Relationship to child
Add Household Member 6
- Add
Household member 6
Member 6 Name
Member 6 Date of Birth

Day
Month
Year
Member 6 Relationship to child

About your child
Is your child attending any of the following?
- Paediatrician
- Speech & Language Therapy
- Physiotherapy
- Occupational Therapy
- Orthoptist / Eye Clinic
- Audiology / Ear, Nose and Throat (ENT) Clinic
- Child and Adolescent Mental Health Services (CAMHS)
- Continence (bladder and bowel problems)
- Other
If your child is attending another clinic, please specify
Are your child's immunisations up to date (including pre-school booster)?*
If unsure or not up to date, please contact your GP.
- Yes
- No
- Unsure
Which immunisations are outstanding?
Does your child have an appointment with the GP for these immunisations?
- Yes
- No
Is your child registered with a dentist?*
If your child is not registered with a dentist please visit www.nhs.uk/service-search to find your local practice
- Yes
- No
When was the last time your child visited the dentist?
Do they attend 6 monthly check-ups?
Does your child have a long-term health condition?*
- Yes
- No
If your child has a long-term health condition, please specify*
Does your child suffer from any severe allergies?*
- Yes
- No
If your child suffers from any severe allergies, please specify*
Do you have any concerns about your child with any of the following
We may be able to provide some resources
- Eating habits
- Sleeping
- Behaviour
- Speech & Language
- Excessive clumsiness
Does your child have any toileting or bedwetting problems?*
- Yes
- No
Do you have any concerns regarding your child being under or overweight?*
- Yes
- No
Please explain your concerns
Is your child on any medication?*
- Yes
- No
If your child is on medication, please give details*
Does your child have any vision problems?*
Your child will have a vision check at 4 years. If this has not been done or you have any concerns about your child’s vision now or in the future, please contact any local opticians for a free eye test.
- Yes
- No
Does your child have any hearing problems?*
- Yes
- No
CAPTCHA

Share this page

Page last reviewed: 13/01/2023

Follow us on social media for all the latest news and announcements

Trust Headquarters

St Catherine's Health Centre, Derby Road, Birkenhead, Wirral CH42 0LQ

Telephone

0151 514 2888

Services

For service contact details please visit the relevant service page

StaffZone
Freedom of Information
Contact
Accessibility
Help
Translations

© Copyright 2024 Wirral Community Health and Care NHS Foundation Trust.

All rights reserved.

Lovingly crafted by Mixd