Letter-size PDF with print-friendly spacing and page breaks.
Printable parent worksheets
These worksheets are designed to prepare for care, not to diagnose a child or calculate whether a diet is adequate. Print or copy only what is useful. Do not place identifying child information in a public repository.
Appointment preparation
Date prepared: ____________________ Appointment: ____________________
Main concern in one sentence:
What changed, and when?
What the child reliably eats and drinks:
What happens around meals:
Symptoms or safety observations:
☐ pain ☐ nausea ☐ constipation ☐ vomiting ☐ gagging ☐ coughing/choking ☐ fatigue ☐ fear/distress ☐ sleep change
Questions for the care team:
Short observation log
| Date / setting | Offered or expected | What I observed | What helped or worsened it | Question for clinician |
|---|---|---|---|---|
Record observations, not labels. Avoid calorie scoring or forced intake unless a clinician has given individualized instructions. This approach is consistent with feeding/swallowing guidance, ADHD care that gathers information across settings, and clinician-led evaluation of symptoms such as constipation.[1][2][3]
School communication sheet
What the school should know about access, meals, attention, or transitions:
Supports to discuss:
☐ predictable transition ☐ safe food access ☐ hydration plan ☐ quieter setting ☐ extra time ☐ neutral prompt ☐ communication method ☐ nurse/caregiver contact plan
What should prompt contacting the family or clinician?
Consent and privacy reminder: Share only the information needed for the school plan and follow local consent and privacy rules.
Provider-fit checklist
☐ pediatric experience for this age
☐ ARFID or restricted-eating experience
☐ pediatric feeding/swallowing competence where relevant
☐ explains role boundaries and referrals
☐ coordinates with primary care, school, and other clinicians
☐ explains cost, insurance, referral, waitlist, language, telehealth, and location limits
☐ protects safe foods, hydration, dignity, and the child’s ability to pause
Care coordination while waiting
This optional worksheet is an information-organizing aid for caregivers preparing for a care or school conversation. It is not a treatment or monitoring plan. Leave anything blank that is not useful; stop if completing it increases distress or delays care. For worsening symptoms or urgent concerns, contact the care team or use red flags and urgent help.
Main concern / what changed:
First person or service to contact:
Questions to ask:
Who will follow up, and when?
Child or young person's voice (optional): “What would you like the care team to understand?”
Do not delay urgent care to complete this sheet. Keep established safe foods and usual fluids in place and follow the child's existing clinician-directed plan; do not make medication, diet, supplement, or feeding-plan changes based on this worksheet. Keep completed copies private; do not publish records or identifying details.
Sources
- ASHA: Pediatric Feeding and Swallowing — observation, safety, and team-care context.
- CDC: Clinical Care of ADHD — information from home, school, and care settings.
- NIDDK: Constipation in Children — symptom-tracking and clinician discussion context.