Resource Room

Registration

Step 1 of 3

This helps us get to know your child before we begin. There are no right answers — please write what feels true. Everything you share stays confidential.

Family & contact details

Parent name

Relationship to child

MotherFather

Mobile Phone

Email

Area / locality

How did you hear about us?

About your child

Child's name

Date of birth

Age

School Name

Class

Languages used at home

In your own words

What your child enjoys and is good at

What you'd like some support with

Anything you've noticed lately

A little developmental history

Health notes, or any earlier assessment or support

What the teacher has said, if anything

I give permission for Resource Room to observe and note my child's learning during sessions. I understand this is used only to support my child, and is kept confidential.