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Newborn Care of The Hamptons Intake Form
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Parent(s) full name
Your answer
Location
Your answer
Due Date or Baby’s Birth Date
MM
/
DD
/
YYYY
Singleton, twins, multiples?
Singleton
Twins
Multiples
Clear selection
Was baby born full term or early?
Yes
No
Still waiting for arrival
Clear selection
Is there anything I should know about their delivery?
Your answer
Are you first time parents or seasoned baby wranglers?
First time parents
Been there done that!
Clear selection
What is your main goal in hiring an NCS?
Your answer
Do you have any parenting philosophies you follow?
Your answer
How soon do you need someone to start?
MM
/
DD
/
YYYY
How long would you like help for and how many days a week?
Your answer
What is your ideal schedule?
Overnights
Daytime
24/7
24/7 at first then followed by nights
Clear selection
Please list your contact information
Your answer
Submit
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