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Parents relating to each other and to the children |
Children relating to the parents |
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My birth mother Her name Her birth date Location Her nationality |
My birth father His name His birth date Location His nationality |
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Was your birth mother present in your home? Yes ____ No ___ If your mother was not your primary caregiver, who was________________________________ What atmosphere did your mother/primary caregiver bring? ________________________ Five words that describe your mother/primary caregiver
What are three things you learned from her? Mark + if positive or – if negative
How did she discipline you? Was it without harshness? ______________________________________ ______________________________________ ______________________________________ How does/did your mother show love to you?
Other insights about your birth mother . . . |
Was your birth father present in your home? Yes ____ No ____ If your father was not your primary caregiver, who was___________________ What atmosphere did your father/ father figure bring? _________________________ Five words that describe your father/ father figure
What are three things you learned from him? Mark + if positive or – if negative
How did he discipline you? Was it reasonably? ________________________________ ________________________________ ________________________________ How does/did your father show love to you?
Other insight about your birth father . . .
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