REQUEST FOR SERVICES | The Faithful Care

This request will take about 7-12 minutes of your time. Please answer all questions as thorough as possible.

Legal First Name

Birthday

Legal Last name

Home Address

Email

Phone Number

Will you pass a background check? Passing is required for service. *

Yes

No

Service(s) Needed? *

Child Care

Pet Care

House Keeping

Transportation

How soon do you require services? Please include start date

How many children need care? What are their ages?

Please list any allergies (if any)

Does your child/ren have any special needs or disabilities? Please be specefic

Do you require a wheelchair-accessible vehicle?

YES

NO

For transportation how many miles from pick up to drop off?

Does the child need a car seat?

YES

NO

Will you provide a car seat for your child?

YES

NO

Do you have any pets? What breed? How many?

Do you prefer a non-smoker? *

Yes

No

Unbothered

Other

How often do you need a provider?

Full-Time

Part-Time

Occasional

Seasonal

Please provide detailed schedule when you would like services provided (include day and times)

If full-time, do you require a live in nanny?

Yes

No

Maybe

Where will the provider give care?

Your Home

Their Home

Other

Please specify your budget for the services required. ($/hr) or (flat rate)

For cleaning ONLY: how many square foot is your home? How many beds/bath? Please include any specefics/special request? Pets, wood floors, special treatment for countertops, etc.

Questions? Comments? Concerns? This is the space to share any details about your family that we should consider when finiding the perfect fit for you.

Speed up your service! Kindly upload a family photo featuring those in need of care. This aids in finding the perfect match quickly and assists in our advertising efforts. Thank you!

Upload supported file (Max 15MB)

**CLEANING ONLY** For percise quoting, kindly upload videos or photos of the areas in need of cleaning. Your privacy is our priority, and all information shared remains confidential. There's no need to tidy up beforeheand; we want to asses the situation a

Upload supported file (Max 15MB)

PET Vaccination Record

Does your insurance policy include child care/transportation coverage?

YES

NO

UNSURE

THE FAITHFUL CARE

The Faithful Nanny Request for Services