Consultation Form
Provide your household details, childcare needs, and preferences to help us find the best fit for your family.
Parent / Household Information
Parent/Guardian Name(s)
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Method of Contact
*
Please Select
Email
Phone
Text Message
Other
Home Address City/Neighborhood
*
Child(ren) Information
Child 1 Name
*
Child 1 Age
*
Child 1 Allergies, Medical Conditions, or Special Considerations
*
Child 1 School or Daycare
Child 2 Name
Child 2 Age
Child 2 Allergies, Medical Conditions, or Special Considerations
Child 2 School or Daycare
Child 3 Name
Child 3 Age
Child 3 Allergies, Medical Conditions, or Special Considerations
Child 3 School or Daycare
Type of Care Needed
Type of Care Needed
*
Full-time
Part-time
Newborn care
Infant care
After-school care
School holiday care
Occasional/date-night care
Backup care
Overnight care
Travel care
Other
Desired Start Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Anticipated Length of Care
*
Please Select
Short-term (1-3 months)
Medium-term (3-12 months)
Long-term (1 year+)
Ongoing
Temporary/As needed
Other
Schedule Needed (days and hours)
*
Nanny Experience & Preferences
Desired Experience Level
*
Please Select
Entry-level
Some experience
Experienced
Highly experienced
Open to any level
Required Skills / Certifications
*
Newborn experience
Infant experience
Toddler experience
Special needs experience
CPR certified
First Aid certified
Water safety training
Meal preparation
Homework help
Driver with clean record
Pet friendly
Other
Language Preferences
*
Open to Nanny Bringing Their Own Child?
*
Yes
No
Maybe
Household Expectations
Child-Related Housekeeping Duties
*
Laundry
Meal Preparation
Toy/Play Area Organization
Children's Dishes
Children's Room Tidying
Homework Station Cleanup
Other
Will Driving Be Required?
*
Yes
No
Are There Pets in the Home?
*
Yes
No
Pet Details (if applicable)
*
Are There Cameras in the Home?
*
Yes
No
Camera Details and Transparency Notes
*
Compensation & Benefits
Pay Range (Hourly or Salary)
*
Guaranteed Hours per Week
*
Paid Time Off / Sick Days
*
Other Benefits Offered
*
Care Philosophy & Values
Parenting Style
*
Please Select
Gentle parenting
Authoritative
Attachment-focused
Structured/routine-based
Flexible/adaptive
Other
Values Important in a Caregiver
*
Kindness
Patience
Reliability
Proactive communication
Respect for routines
Safety-conscious
Creative play
Educational focus
Flexibility
Other
Anything Else We Should Know About Your Family or Home Environment?
*
Submit
Should be Empty: