Name* First Last PhoneEmail* Office Location*San DiegoOrange CountyLos AngelesRiverside County-Palm SpringsPortlandSan FranciscoNew YorkOtherHow many children do you have within your family or group?What type of services interest you?* Short term sporadic full employment services Short term consistent full employment services Back-up corporate care (interested in benefit program or referral source for employees only) Long term need over 6 months referral services School@Home Private Educator Support in home School@Home Virtual Education Support You can select more than one option.Are you trying to put together a learning pod if School@Home?Approximately how many hours per week are you looking for? Under 15 15-25 25-40 40+ Where do you fall on the risk tolerance scale below related to the COVID Risk Tolerance Scale? * Very strict-Not leaving home not socializing, always wearing mask for interaction with anyone outside of the home, concerned as they may live with someone immunocompromised Strict-socializing only with people living in their home always wears masks only leaving for essential items and social distancing Fairly Strict-leaving for work, exercise, social outdoors only wearing mask when not socially distanced Somewhat open-leaving for work, exercise, socializing with small trusted group, wears mask and social distances Moderately open-leaving for work, exercise, other shopping and activities, visitors allowed in home and small social circles, not always maintaining social distancing Very open-socializes without mask or recommended etiquette, no extra precautions, not concerned with infection I am comfortable paying per hour: $15 or below $16-20 $20-25 $25-30 $30-35 $40 plus This is to help us have an idea of what service would be most applicable to your family long term. It will, of course, depend on the qualifications of the person you are hiring. How did you discover us?* Δ
