Cozy Corner's Questionnaire
Please fill out this form to the best of your ability for all children you'd like to enroll. No answer is wrong, so please answer truthfully and submit upon completion. Please contact the provider at cozycornermuskego@gmail.com with any questions you may have. Your answers will be reviewed and you will receive a response once a decision has been made. Thank you for your time and interest in Cozy Corner!
Sign in to Google to save your progress. Learn more
What is your name and email address? *
What is your child's name, age and gender? (Include all children you'd like to enroll) *
What is your child's birthdate? (If unborn, specify due date) *
What days and hours (between 7:15 a.m. and 4:30 p.m.) would you need care for? *
When would you like your child to begin care?  *
Does your child have any special needs based on religion, learning disabilities or medical conditions? Medication taken? *
Does your child have any food or environmental allergies? What is the treatment? (Please note that the provider has dogs that are primarily kept away from the children) *
What would you do with your child if you got an unexpected day off of work/school? *
What type of parenting style/discipline techniques do/will you use? *
Cozy Corner offers a Product Program consisting of diapers, training pants, baby wipes, diaper creams, sunscreen and insect repellent for $5.00/week. Would you be interested in joining this program? (No fee to join or cancel) *
Has your child been in a child care setting before?  In-home? Group center? Why was care terminated? *
How long do you expect to be needing child care for? *
What are your expectations of a childcare provider? *
What types of things do you wish your child to learn during their time here?
Can you have back up care arranged for provider vacations or emergencies? *
Are there any legal custody arrangements in place for your child? *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms