Q01
Message
All templatesIndustry-Specific
Child Information & Enrollment Profile Survey
Collects the background, health, and behavioral information childcare centers, schools, and youth programs need to support a child well — routines, needs, and preferences alongside an AI follow-up that draws out the specific things a new caregiver should know on day one. Built for intake and enrollment teams.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
15 questions · ~8 min
Q02
Short TextRequired
What is your child's first name (and nickname, if they go by one)?
Q03
DateRequired
What is your child's date of birth?
Q04
Multiple ChoiceRequired
Does your child have any allergies, medical conditions, or medications our staff should know about?
- No known allergies or conditions
- Food allergies
- Other allergies (e.g., environmental, medication)
- Ongoing medical condition
- Takes regular medication
Q05
Long Text
Please describe any allergies, conditions, or medications in detail, including what we should do in an emergency (e.g., EpiPen location, dosage instructions).
Q06
MatrixRequired
How would you describe your child in each of these areas?
5 rows × 5 columns
- Separating from parents/caregivers
- Following instructions from a new adult
- Playing with unfamiliar children
- Trying new foods or activities
- Managing frustration or disappointment
Columns: Struggles a lot · Struggles a little · Neutral · Does well · Does very well
Q07
Multiple Choice
Which best describes your child's daytime nap or rest needs?
- Needs a scheduled nap
- Rests only if tired
- No longer naps
- Not applicable / unsure
Q08
Long Text
Describe your child's typical daily routine (meals, naps, comfort items) so we can keep things consistent for them.
Q09
Opinion ScaleRequired
How confident are you that our team currently understands your child's individual needs?
Scale: 1 – 7
Min:Not confident at allMax:Extremely confident
Q10
AI Interview
Explore the one or two things this parent is most anxious about for their child in a new care setting — anchor on whatever they rated lowest in confidence or flagged in the routine/behavior questions. Ask for a specific recent example of what helped (or didn't) when someone unfamiliar cared for their child, and what a caregiver should do differently in the first week. If they say everything is fine, ask what would make them feel even more confident.
Q11
Short TextRequired
Who should we contact first in an emergency, and what is the best phone number to reach them?
Q12
Multiple Choice
Is there anyone who is NOT authorized to pick up your child?
- No restrictions
- Yes — details below
Q13
Long Text
If there are pickup restrictions or custody arrangements we should know about, please describe them here.
Q14
Multiple Choice
What is your child's gender?
- Boy
- Girl
- Non-binary
- Prefer to self-describe
- Prefer not to say
Q15
Message
Thank you for sharing this — it goes directly into your child's care profile so our team can support them from the very first day. You can update these details any time by contacting us.
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- Goes beyond checkbox allergy fields with a dedicated long-text prompt asking for the specific allergy, condition, or medication details and what staff should do about them
- Includes an AI follow-up interview that draws out the one or two things a parent is most anxious about for their child, so caregivers get context no static form captures
- Combines structured intake (DOB, nap needs, emergency contact, pickup authorization) with a behavioral matrix and an opinion-scale check on how confident staff feel about knowing the child already
- Frames the whole survey around day-one caregiving needs, closing with a message confirming the data feeds directly into the child's care profile
Jotform
Child Information Form TemplateA ready-to-use, drag-and-drop form template for collecting basic child and guardian information. It's built for quick deployment and customization within Jotform's form builder ecosystem, but it functions as a static data-collection form rather than an interview. Best suited to centers that just need to capture fixed fields, not probe deeper on a parent's specific concerns.
What it does well
- Easy to customize via drag-and-drop form builder
- Fielding-ready template that integrates with Jotform's broader form/workflow ecosystem
- Likely supports common field types (text, date, multiple choice) out of the box
Where it falls short
- No adaptive AI follow-up — every parent sees the same static questions regardless of their answers
- No voice AI interview option or guided screen-share tasks
- No automated per-response quality scoring or auto-generated reports
SurveySparrow
Child Information Form Template | For Educational & Healthcare ProvidersA conversational-style child information template pitched specifically at educational and healthcare providers, which makes it a close comparison for intake teams. It emphasizes a friendlier chat-like UI for form-filling, but it remains a fixed-question template rather than a true adaptive interview. There's no indication it can dynamically probe deeper based on a parent's specific responses.
What it does well
- Conversational UI designed to feel less clinical for parents filling it out
- Positioned directly at educational and healthcare provider intake use cases
- Likely offers standard customization and branching logic common to SurveySparrow forms
Where it falls short
- No adaptive AI-driven follow-up questions that dig into individual parent concerns
- No voice AI interview mode or guided screen-share task support
- No transparent, publishable prompt methodology or automated quality scoring of responses
Frequently asked questions
What questions are in the “Child Information & Enrollment Profile Survey” template?
The template includes 15 ready-to-use questions, starting with: “<p>Welcome! To help us care for your child well from day one, we'd like to learn a bit about them — routines, needs, and…” · “What is your child's first name (and nickname, if they go by one)?” · “What is your child's date of birth?”. The full set is previewed above, and every question is editable.
How long does this survey take to complete?
Respondents typically finish the 15 questions in about 8 minutes.
Can I customize this template?
Yes — every question, answer option, and the ordering is editable before you launch. You can add or remove questions, or ask the AI editor to rework the survey around your research goal.
Is this template free to use?
Yes. Open it in the editor and start customizing right away — no account required to try it, and the free plan covers launching your survey.
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.
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