On-Call & Temporary Solutions

Family Application

What locations will the position take place?

Full name *

Please provide your full name.

Email *

Please provide your email address.

Phone *

Please provide your phone number.

Occupation *

Partner's Full Name (If Applicable)

Partner's Email Address (If Applicable)

Partner's Phone Number (If Applicable)

Occupation *

Street Address *

City *

State *

Zip Code *

Emergency Contact

Emergency Contact's Full Name *

Emergency Contact's Phone Number *

Emergency Contact's Email Address

Emergency Contact's Address

Service Request Information

Tell us what type of service you're looking for. *

Flex Care-Specific Roles *

On-Call Nannies Temporary Nannies Travel Nannies Newborn Nannies & Specialists Pet Care Provider

Corporate & Organizational Solutions

On-Call Nannies Corporate Backup Care Church & Ministry Support Hotel & Resort Partnerships Theme Park & Vacation Coverage

Event Childcare

Event Childcare Lead Event Staff & Planners Travel & Venue Coordination Other

What is your desired start date for this role? *

What is your desired end date for this role? *

Any "tricks of the trade" our caregiver should know before that could set them up for success?

Family Details

Please tell us more about the temporary or on-call services your family needs. *

Please share any other information that would be helpful for us to know regarding your family and the position you are looking to fill. *

Do you have Pets? Please list all, including the type and breed. *

Is any child or another member of your household under the care of a physician or mental health professional for any physical, emotional, developmental or behavioral issues? *

Yes No

Children Information

Your children *

Please tell us about your children.

Child #1

Child's name

Child's gender

Child's age

Describe your child

Screen policy - is your child allowed to use tablets/watch TV? *

Yes No

If screentime is allowed in your home, what does it look like? Are there limits? Favorite things to watch?

What is your relation to this children/child? *

What is your emergency contact's relation to this child? *

Tell us a little about your child's personality.

Please share your child's interests and hobbies (if applicable)

Please describe any special needs your child may have: medical (eg. allergies), discipline issues, etc. *

What does naptime or bedtime routine look like in your house?

What does mealtime routine look like in your house?

Please upload a picture of your family.

These image will NOT be shared outside of our team. They are used to help our care providers feel like they know you before coming to your house!

How did you hear about us? *

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Yes