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Babysitter Information Sheet
By iParenting Staff
The following is a printable list that provides pertinent information for your child's babysitter while you are away.
Phone Number:___________________________________
Family Information
Our Family's Name:_____________________________
Our Home Address:_____________________________
Nearest Cross Streets:_____________________________
Home Phone:_____________________________
Work Phone:_____________________________
Cell Phone(s):_____________________________
Emergency Contact Name(s):_____________________________
Emergency Contact Address and Phone:_____________________________
Numbers to Know
Police Department:_____________________________
Fire Department:_____________________________
Gas Company:_____________________________
Electric Company:_____________________________
Taxi Service:_____________________________
Poison Control:_____________________________
Pediatrician:_____________________________
Pediatrician Phone:_____________________________
Address:_____________________________
Hospital:_____________________________
Address:_____________________________
Hospital Phone:_____________________________
Other Important Phone Numbers:_____________________________
Neighbor Information
Name:_____________________________
Address and Phone:_____________________________
Name:_____________________________
Address and Phone:_____________________________
Health Insurance Information
Company:_____________________________
Group Number:_____________________________
ID Number:_____________________________
Child(ren)'s Information
Name:_____________________________
Date of Birth:_____________________________
Age:_____________________________
Weight:_____________________________
Height:_____________________________
Allergies:_____________________________
Foods Not Allowed:_____________________________
Medical Condition(s):_____________________________
Medications/Dosage:_____________________________
Name:_____________________________
Date of Birth:_____________________________
Age:_____________________________
Weight:_____________________________
Height:_____________________________
Allergies:_____________________________
Foods Not Allowed:_____________________________
Medical Condition(s):_____________________________
Medications/Dosage:_____________________________
Name:_____________________________
Date of Birth:_____________________________
Age:_____________________________
Weight:_____________________________
Height:_____________________________
Allergies:_____________________________
Foods Not Allowed:_____________________________
Medical Condition(s):_____________________________
Medications/Dosage:_____________________________
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