Intake Form- Sitters

Child’s Name*

Age of your Child*

Is there a gate code for your neighborhood? If yes, please list. (Please write N/A if not applicable)*

If hotel, please list room number. (We will be in contact if you do not know it yet) Please write N/A if not applicable.*

Date of Service*

Hours of Service (reminder that we do have a 3 hour minimum)*

Do you have any pets? If so, what animal?*

Is your pet friendly?*

Yes

No

N/A

Will the sitter need to care for your pet during time of service?*

Yes

No

N/A

Are you comfortable with the sitter to drive your children if necessary.*

Yes

No

If driving, do you have a family car that the sitter can use while on shift or will the sitter's car be used? If sitters car, you will need to provide car seats if necessary.*

Does your child have any allergies (food, medication, etc.)? If yes, please list.*

Does your child take any medications? Will the sitter be in charge of administering it? Please list dosage and times for medication.*

Emergency Contact: Parents Phone Number (Parent 1- please write name and phone number)*

Emergency Contact: Parents Phone Number (Parent 2- please write name and phone number)*

Emergency Contact- Neighbor or Close Relative. In case sitter can’t get in contact with parents. (Please write relation and phone number)*

What are your child's likes and dislikes? (Favorite food, toys, games, activities, shows, etc.)*

Please let us know any special considerations for your children.*

Family Picture*

Please upload a picture of your family, your sitter will be the only who sees the photo. It will not be shared anywhere else. We want our sitters to feel comfortable just as much as you want your kids to. You will also be sent a picture of your sitter.

Is your sitter allowed to take pictures of your children?*

Yes, and is allowed to be used for marketing on social media

No, pictures are not allowed to be taken

How did you hear about The Sister Sitters?*

Discount Code

Signature*

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