Personal family questionnaire is a methodology followed by many organizations when it comes to assist a family in their personal matters. These personal matters include baby sitting, taking care of an elderly and/or sick person, or simple household jobs for the entire day. These types of questionnaires prove to be very helpful in various deciding various types of tasks.

Sample Personal Family Questionnaire


Details of the host family:

1)   Name and age of the host mother:


2)   Her profession:


3)   Hours she stays away from home:


4)   Name of the host father:


5)   His profession:


6)   Hours he stays away from home:


7)   Do either of parents work :

a)   Yes

b)   No

8)   Home address:


9)   Contact no. of the head of the family:


10)               Email ID of the head of the family:


11)               Number of children to be taken care of:


12)               Details regarding those children:

(including their likes and dislikes, the type of foods they eat, their hobbies etc.)

__________________________________________________________________  ____________________________________________________________

13)               The language spoken at home:


14)               Do the children speak any other language? If yes, please specify.

a)   Yes

b)   No


15)               Do any of the family members have any physical or mental disability? If yes, please specify.

a)   Yes

b)   No


16)               Does your family possess any special dietary habits? If yes, please specify.

(for example: vegetarian dishes on certain days etc.)

a)   Yes

b)   No


17)               Are there any pets in the household? If yes, please specify.

a)   Yes

b)   No