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Parental Post Placement Report
Basics... 
Country:
Today's Date:
Name of Child:
Original Name of Child:
Parent(s) Names:
Birth Date of Child:
Region of Orphanage:
Date of Adoption / Court Date:
Health Status... 
Current Height:
Current Weight:
Current with Immunizations?:
Is your child in good health?:
If the answer is No, please provide any Health / Medical Concerns and Explainations:
Is your child receiving any of the following?... 
Attachment services?:
Early Intervention services?:
Occupational Therapy?:
Physical Therapy?:
Speech Therapy?:
Other?:
If Yes, please explain:
Does your child display any eating or sleeping concerns?:
If Yes, please explain:
Fine and Gross Motor Skill Development... 
Rolling over?:
Sitting on own?:
Crawling?:
Pulling self up / Standing?:
Walking?:
Drinking from Sippy Cup?:
Holding Utensils?:
Using Pincer Grasp?:
Additional Development... 
Extra Curicular Activities:
Language Development:
Social Adjustment / Behavior:
Relationship With Parents / Siblings:
Achievements and Milestones:
Do You need a Social Worker help call?:
If yes, what is your concern?:
After submitting this document, you MUST email several recent photographs in JPEG or JPG format (.JPG) of your child to postplacement@eaci.com.