Please provide the essential details for tonight's sitting arrangement. All contact information is critical for safety.
Parent(s) or Pet Owner(s) Full Name(s)
Primary mobile number while out
Secondary mobile number (if applicable)
Expected sitter arrival time
Estimated return time
Backup contact person who will be available tonight
Will you be at a location with unreliable cell reception?
Venue name and any available landline number
Is there a possibility you may return later than the estimated time?
Latest possible return time
Type of care required tonight
Childcare only
Petcare only
Both children and pets
Number of children requiring care
0
1 child
2 children
3 children
4 or more children
Children Details & Profiles
Child's Full Name | Age & Date of Birth | Pronouns/Preferred Name | Personality, Temperament & Special Needs | Typical Bedtime Behavior & Sleep Patterns | ||
|---|---|---|---|---|---|---|
A | B | C | D | E | ||
1 | Emma Thompson | 5 years (born 2019-03-15) | She/Her | Energetic, loves stories, can be anxious around new people | Fights bedtime, needs multiple stories, sleeps with nightlight | |
2 | Oliver Thompson | 2 years (born 2022-07-22) | He/Him | Shy initially, very attached to his blanket, non-verbal | Goes down easily but wakes if blanket is missing | |
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Number of pets requiring care
0
1 pet
2 pets
3 pets
4 or more pets
Pets Details & Care Profiles
Pet's Name | Species & Breed | Age | Behavioral Traits & Special Needs | Feeding & Care Requirements | ||
|---|---|---|---|---|---|---|
A | B | C | D | E | ||
1 | Max | Golden Retriever, 3 years old | 3 | Friendly but barks at strangers, loves fetch, scared of thunderstorms | Feed 1 cup kibble at 6 PM, needs walk at 7 PM, give thunder shirt if storm starts | |
2 | Whiskers | Domestic Shorthair Cat | 7 | Independent, hides from loud noises, uses litter box | Feed wet food at 6:30 PM, clean litter if needed, keep indoor only | |
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⚠️ CRITICAL SAFETY INFORMATION: Provide at least TWO local emergency contacts who can respond within 10 minutes and are aware they may be contacted tonight.
Primary Emergency Contact - Full Name
Primary Contact - Relationship to Family
Primary Contact - Primary Phone Number
Primary Contact - Secondary/Work Phone
Secondary Emergency Contact - Full Name
Secondary Contact - Relationship
Secondary Contact - Phone Number
Family Doctor/Pediatrician Full Name
Doctor's Emergency/After-Hours Contact Number
Preferred Hospital/Clinic Name
Hospital/Clinic Address & Directions from your home
Veterinarian Name & Clinic (if pets are being cared for)
Veterinary Emergency Hospital Number
Local Emergency Services Number (Police/Fire/Ambulance)
Poison Control Center Emergency Number
Home Security Company Name & Emergency Dispatch Number
Specific Emergency Protocols (e.g., lockdown procedures, medical action plans)
Does anyone being cared for have known allergies (food, environmental, medication, pet)?
⚠️ ALLERGY DETAILS: List each person/pet, specific allergens, severity (mild/moderate/severe/anaphylactic), and EXACT emergency response required. Include location of medications.
Are there any prescription or over-the-counter medications that MUST be administered tonight?
Medication Administration Log
Name of Person/Pet | Medication Name & Exact Dosage | Scheduled Administration Time | Administration Instructions & Side Effects to Watch For | Administered (sitter to check) | ||
|---|---|---|---|---|---|---|
A | B | C | D | E | ||
1 | Emma | Children's Zyrtec 5mg | 7:00 PM | Give with water, may cause drowsiness | ||
2 | Oliver | Multivitamin drop 1ml | 6:30 PM | Mix into food, do not give directly | ||
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Medical Conditions, Disabilities, or Special Needs the Sitter Must Be Aware Of
Emergency Action Plan for Critical Conditions (seizures, allergic reactions, asthma attacks, etc.)
Location of First Aid Kit
Location of Emergency Medications (EpiPens, inhalers, rescue meds)
Are there any recent illnesses, injuries, or health concerns?
Describe symptoms, care needed, and when to be concerned
Detailed schedule to maintain consistency and comfort. Include specific times, activities, and special instructions for each block.
Tonight's Routine Flow
Time Block | What Needs to Happen (Feeding, Wind-down, Bedtime, Medication, etc.) | Comfort Tricks & Specific Instructions | ||
|---|---|---|---|---|
A | B | C | ||
1 | 6:00 PM - 6:30 PM | Dinner time - serve pre-made meal from fridge | Must use BLUE plate for Emma, RED plate for Oliver. Cut food into small pieces. Allow TV watching during meal. | |
2 | 6:30 PM - 7:00 PM | Free play and cleanup time | Favorite toys are in the blue bin. Encourage putting away 5 toys before continuing. Max (dog) needs to be let out in backyard. | |
3 | 7:00 PM - 7:30 PM | Bath time for both children | Use lavender soap only. Fill tub to 4 inches maximum. Oliver gets anxious - sing 'Twinkle Twinkle' to calm him. Constant supervision required. | |
4 | 7:30 PM - 8:00 PM | Wind-down routine in bedroom | Put on white noise machine (HIGH setting). Read exactly 3 stories from the bookshelf. Use specific BLUE blanket for Emma. Oliver needs his stuffed giraffe. | |
5 | 8:00 PM - 8:15 PM | Final bedtime preparations | Both children need water cups at bedside. Nightlight must be ON. Door stays OPEN 6 inches. No talking after lights out. | |
6 | 8:15 PM onwards | Quiet monitoring | Check on children every 30 minutes. Whisper only. Feed cat at 8:30 PM. Dog can have bedtime treat from jar on counter. | |
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Is there flexibility in this routine if things don't go as planned?
Explain what can be adjusted and what elements are NON-NEGOTIABLE
⚠️ CRITICAL: This routine must be followed exactly as written. Any deviations may cause significant distress. Contact parents immediately if unable to complete any step.
Should the sitter maintain a log of activities, moods, or incidents?
What specific details should be logged and where to leave the notes
Which areas of the home are STRICTLY OFF-LIMITS tonight? (Select all that apply)
Master bedroom
Home office/study
Basement/storage areas
Garage
Backyard after dark
Swimming pool area
None - all areas are accessible
Other restricted areas
Detailed access rules: cabinets, closets, or rooms that require permission
Do you have a security alarm system that must be managed?
Provide alarm code, arming/disarming sequence, password for calling security company, and what to do if it accidentally triggers
Emergency exit routes, fire safety meeting point, and emergency procedures
Are there any safety hazards the sitter should be extra cautious about?
Describe hazards (e.g., steep stairs, pool, aggressive pet in neighbor's yard) and safety precautions
Can the sitter use kitchen appliances (oven, stove, microwave, dishwasher)?
Specify which appliances are approved and any safety instructions
⚠️ Kitchen Appliances OFF-LIMITS: Use only pre-prepared foods and microwave for reheating only.
Wi-Fi Network Name & Password (for emergency use)
SPECIFIC Comfort Items That MUST Be Available (describe exact item, location, and why it's critical)
Does anyone have specific bedtime fears, separation anxiety, or emotional triggers?
Describe fears/triggers and proven calming strategies that work
Are there any behavioral challenges or discipline approaches we use?
Explain our discipline philosophy, what works, what to avoid, and when to call us
Most effective soothing techniques when upset or crying (include specific songs, phrases, or actions)
Is it acceptable to take photos or videos to share moments during the evening?
Specify what is acceptable to photograph and how to share (e.g., via text, not social media)
📵 NO PHOTOS/VIDEOS: Please respect our privacy and do not take any photos or videos of our children, pets, or home.
Has dinner already been served before sitter arrival?
DINNER INSTRUCTIONS: What to serve, how to prepare, portion sizes, where to find food, and any mealtime rules
Approved snack options, portion limits, timing, and where to find them
Are there any choking hazards, forbidden foods, or severe allergy risks?
⚠️ CRITICAL FOOD RESTRICTIONS: List forbidden foods, why they're dangerous, and what to do if accidentally ingested
Do infants need bottle preparation or specific feeding equipment?
Bottle prep: formula mixing ratios, water temperature, sterilization, storage, and feeding schedule
PET FEEDING: Food type, exact amount, location, feeding times, and special requirements
Food-related behavioral notes (e.g., picky eating, food guarding in pets, mealtime tantrums)
Screen time policy for tonight
No screens allowed at all
Limited time only (specify below)
Educational content only with time limits
Use your best judgment
Other specific rules
Specific screen time rules: approved shows/apps, time limits, cutoff times, and devices allowed
Approved activities and toys for tonight (select all that apply)
Board games and puzzles
Arts and crafts supplies
Outdoor play and sports
Reading and storytime
Building blocks and LEGO
Musical instruments
Pet playtime and exercise
Homework or learning activities
Other
Homework assignments, reading requirements, or educational activities that must be completed
Pet exercise, play, and enrichment instructions (walk routes, favorite toys, duration)
Activities to AVOID or that are off-limits tonight
Thermostat settings and temperature adjustments (e.g., keep at 72°F, don't adjust below 70°F)
Tricky light switches, lamps, or lighting preferences for evening routine
Are there any complex devices (TV, sound system, smart home devices) the sitter may need to operate?
Device instructions: remotes, apps, settings, and troubleshooting tips
White noise machine, nightlight, or other comfort device locations and exact settings
Additional light household tasks (if time permits and children/pets are settled)
Are you expecting any visitors, deliveries, or service providers tonight?
Visitor details: name, expected time, purpose, whether to allow entry, and any verification required
Total sitter payment amount for tonight
Payment method and location (cash, digital transfer, app, etc.)
Should the sitter answer the house phone if it rings?
What message to take or how to screen calls
Is there a spare key available if you are delayed or in case of emergency?
Key location and any instructions
Any other special instructions, requests, or important information not covered elsewhere
To be completed by the sitter at the end of the evening.
Actual departure time (sitter to complete)
Evening summary: What went well, any challenges, notable behaviors, or incidents
Did any emergencies or concerns arise that require immediate parent notification?
URGENT: Describe what happened and actions taken
Please rate how each child/pet handled different aspects of the routine
Very Difficult | Difficult | Neutral | Cooperative | Very Cooperative | |
|---|---|---|---|---|---|
Emma - Following dinner routine | |||||
Emma - Bath time cooperation | |||||
Emma - Bedtime transition | |||||
Oliver - Following dinner routine | |||||
Oliver - Bath time cooperation | |||||
Oliver - Bedtime transition | |||||
Max (dog) - Evening behavior | |||||
Whiskers (cat) - Evening behavior |
I have read, understood, and will follow all instructions to the best of my ability
Sitter signature acknowledging receipt and understanding of all instructions
Sitter arrival time confirmation (to be filled upon arrival)
To configure an element, select it on the form.