Contact Us
Ph.(520) 322-6966
Fax.(520) 320-7711
2504 E. River Rd.
Suite 100
Tucson, AZ 85718

If calling after business hours and immediate service is required, please call (520) 322-6966 to be connected to our answering service.

PLEASE NOTE:
EMAIL REQUESTS SENT AFTER 5:00 P.M. WILL NOT BE RECEIVED UNTIL 8:00 A.M. THE FOLLOW BUSINESS DAY.
RequestService
registration 
Request for Service
Parent/Guardian*: 
Parent/Guardian: 
Phone*:
Email:
I am a:
Job request date: 
Start time:   :   
End time:   :   
ALL JOBS WILL BE CONFIRMED PRIOR TO START TIME
Type of job: 
Are you willing to have a male nanny?
 
Are you willing to have a nanny that has to come with her own child?
 
Misc. notes (new address, phone number, additional children to be cared for, pick up, drop off, flexible time request, etc.)
 
How did you hear about us?

 
If 'other' or 'referral', please tell us who to thank:
 
Where would you like to receive confirmation? 
 
Corporate Care
Are you a Corporate Care Client?
 
Name of company: 
Sick or Emergency Back-up Care: 
 
If sick care, please provide details (childrens name, brief description of illness) 
 
If back-up care, who & how many children will be home? 
 
If ChoiceCareAgency does not have a current credit card on file, we will not proceed with the request. Please contact office to provide credit card.
Hotel Care
Are you staying in a hotel?
 
Name of hotel: 
Room #: 
Hotel phone:   -   - 
(if unknown, please contact us upon arrival)
Where would you like your Choice Care Nanny to meet you?
 
Smoking household?
 
Comments: 
 
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