Above & Beyond Nanny Services, Inc.
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COVID-19 Readiness Form: Families
COVID-19 Readiness Form
Covid 19 Information page
Thank you for contacting us! If needed, you will hear back within 48-72 hours.
Email:
*
Check here to receive email updates
Please describe any other details you wish to share or precautions you are taking:
*
Do you or your household members work remotely at home, or leave for work?
Do you have any household members who work in high-risk situations?
Yes
No
Phone Number:
*
If eligible - have you received the COVID vaccine?
Yes
No
Do you have any close family members you are socially distancing for?
*
Name:
*
Would you be willing to adjust your precautions to align with the family's?
Yes
No
Of the three levels, which most accurately reflects your current level of precautions?
Level 1
Level 2
Level 3
This form will help match you with families with similar COVID levels of exposure and precautions!
The more details the better!
Are you socially distancing?
Yes
No
Are you willing to limit your exposure with friends and others?
Yes
No
How many people are in your household?
0-1
1-2
2-3
4+
Do you wear a mask in public?
Yes
No
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