Babysitter Reference Check Questionnaire Form
Please complete the Babysitter Reference Check Questionnaire Form to help us evaluate the candidate’s suitability for childcare. Your honest feedback is appreciated and will remain confidential.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Babysitter’s Full Name
*
First Name
Last Name
What is your relationship to the babysitter?
*
Parent of child cared for
Relative of babysitter
Family friend
Neighbor
Other
How long have you known the babysitter?
*
Please Select
Less than 6 months
6 months to 1 year
1 to 2 years
More than 2 years
Please rate the babysitter’s caregiving qualities:
*
1
2
3
4
5
Briefly describe the childcare duties the babysitter performed and ages of children cared for.
*
How would you rate the babysitter’s safety awareness and reliability?
*
Excellent
Good
Satisfactory
Needs improvement
Would you recommend this babysitter to other families?
*
Yes, without reservation
Yes, with some reservations
No
Additional comments (optional)
Submit Reference
Should be Empty: