Babysitter Information Form
Healthy Pregnancy Home > Mom-to-Be Tools > Babysitter Information Form
Here
is a form of important information to leave with the babysitter each time you will be away
from home. All you need to do is just print copies of the form, and fill it out for
your babysitter.
My Name:______________________ Cell phone / pager _________________
Child's Name:__________________________________________________
While out, I will be
at:_____________________________at_______________
(location / phone number)
(time)
then at:_______________________________________at_______________
(location / phone number)
(time)
Food / other allergies my child has:________________________________
Snack:______________________________
Time:_____________________
(what kind of snack?)
Bedtime:_____________________________________________________
Activities (books, toys, songs, etc.) my child likes
are:____________________
_____________________________________________________________
Emergency Contacts:
Baby's Doctor:_____________________Phone
Number_________________
Neighbor's name, address, phone
number:____________________________
_____________________________________________________________
Other person to contact in case of
emergency:__________________________
Notes:________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
Current as of June 2007
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