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NICHQ Vanderbilt Assessment Scale—PARENT Informant
Today’s Date: ___________ Child’s Name: _____________________________________________ Date of Birth: ________________
Parent’s Name: _____________________________________________ Parent’s Phone Number: _____________________________
Directions: Each rating should be considered in the context of what is appropriate for the age of your child.
When completing this form, please think about your child’s behaviors in the past 6 mont
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