Client Intake form | Rooted Nannies

First name

Last name

Email

Phone (Make sure to add +1 before your number)

City

State

Neighborhood - if you live in a big city.

Do you have a partner or spouse?

If yes, what is your partner or spouse's name?

Please list the names and ages of children

For nanny placement, describe your children's personalities and interests.

Do your children have any special needs? Please explain. Do they require any extra care (medication, medical devices, therapies, etc)?

What service are you interested in?

Nanny

Nanny Share (we do not match families to each other, please already have the share established. We will find the candidate!)

Household Manager

Newborn Care Specialist

Temp/Travel Nanny

What is your ideal start date?

What days and hours do you need?

Do you currently have a nanny?

If you are expecting, whe is your due date?

Do you have any other household staff? Will they nanny be working alongside other staff?

Expected hourly range $

We require that hired candidates receive paid holidays, sick days, and vacation days. Are there any additional benefits you are interested in giving?

Do you require any flexibility for domestic/international travel?

Is driving a car required? If so, do you have a car for the nanny to drive during work hours or are they expected to use their own?

Do you require your childcare provider to be vaccinated?

What are the most important qualities you look for in a childcare provider?

What type of relationship do you hope to have with your nanny? (Strictly professional, behind the scenes step-in step-out, family-like relationship, etc)

Describe your parenting philosophies including discipline styles.

How did you hear about us?

Family Application