Talk Leader Contact Session Form

 

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Use this form to send me an email about today's talking activity. You cannot type directly on this page. Therefore, this is what you must do: You must be using Netscape Communicator for this to work. Netscape communicator is on the machines at the Rutgers labs (eg at Records Hall)

1: From the FILE menu choose EDIT PAGE

Once you are in edit page mode you can type all the information you need to type on that page.

2. After you finish typing in all the needed information choose from the FILE menu SEND PAGE. It will bring up a blank email form that flashes by quickly and then gets placed on the bottom of the screen with the words Play Leader. Click on that to bring up the email form. Then change the subject from Play Leader Contact Session Form to Activity Name, Kid ID# Date eg Firefighter Frank, 2003, 02/25/98. In the TO: field type yepstein@rci.rutgers.edu Then just click on the send button and the message will be sent.

 

Leader's First name

Last name

Home Phone

E-mail

 

Enter the date of today's Session :

Time of day when session started:

Time of day when session ended:

Information about the child you played with 

Date of birth

Sex: __ Male __Female

Child's ID number:

 

Describe the mood of the child when you began to work with him or her:

 

 

Describe any physical conditions that apply: Here are some examples.

Today the child:

had a cold; had to go to the bathroom; looked sleepy; had trouble concentrating

Now Please describe the physical conditions that apply to your child today.

 

How did you begin this conversation?

  

What was your opening line?

 

What were the topics you covered?

 

What topics seemed most interesting to the child?

 

Who led the conversation?

 

Were there continuing themes?

 

Did the child play with any toys or do any art activities (instigated by the child)

 

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 Material on this site created by Helane S. Rosenberg, Ph.D. and Yakov M. Epstein, Ph.D. in conjunction with their forthcoming book titled Play for Success. All material on this site is copyrighted and may not be reproduced or cited without written permission of Helane S. Rosenberg, Ph.D..

*SEND EMAIL TO DR. ROSENBERG * SEND EMAIL TO DR. EPSTEIN

 

Copyright Helane S. Rosenberg, Ph.D. and Yakov M. Epstein, Ph.D.

Last revised: February 14, 1998