Link 1: This is the children's intake form I use. It's got what you're asking for. (link below)
Link 2: Sohnen-Moe Associates has forms free for your business use. Ms. Sohnen Moe even gives permission to modify them as you see fit. (link below)
Link 3: Also, this MySpace group has SEVERAL additional files available. (link below)
I have these pages bookmarked.
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