Before you book a Sleep Service with me, I’d love to know:

What's your sleep story?

By sharing the information below with me I’ll have a clear overview of your situation which helps me to find the best sleep service for your family.

Your sleep story is one of a kind! Please fill in the form with as much detail as you’re comfortable with. If I need any more information we'll go through it in our consultation together.

PLEASE HAVE A QUICK READ OF OUR FAQS BEFORE FILLING THE SLEEP STORY FORM OUT.

First and Last Name

First Name

Last Name

Email Address

The best telephone number to reach you on:

Are you overseas? Please include full phone number including dialling code.

Child's full name

Child's Age

How would you describe your child's personality and temperament in 3 or 4 words?

How was your pregnancy?

How was your birth?

Birth Weight:

Current weight/centile if known:

Do you have any current weight concerns?

Does your child have any reflux?

Yes

Don't know

If yes: Are they on any medication, and are they currently experiencing any symptoms?

Does your child have any allergies?

Is your child in good health?

Is there any history of any major illness?

What milk feeds does your child have?

What solids (if any) does your child have?

Where does your child sleep?

Do they have a dummy?

Do they have a comforter?

Please can you outline your child's current naps:

Please can you outline your current bedtime routine:

If I had that sleep wand what are your preferable sleep aims?

Have you completed any Care it Out E-Courses?

Bedtime Basics

Bedtime Boundaries

Both

The next sleep steps

Do you have a sleep service preference?

What's your availability?

Do you have any questions?

Please confirm that you've read our FAQs before submitting this form. (Required).

I've read the FAQs

Once you've shared your sleep story I aim to get you booked in for your consultation within 10-14 days, provided I believe I can help you move forward with your sleep situation.

Privacy

This form will be processed by Squarespace and sent to our email address - you will not be added to our mailing list. We will retain this form and any other Data you submit only for as long as required for legal, business, or tax purposes. This information may be retained in paper or electronic form, or a combination of both. When your information is no longer needed, we’ll delete it. By submitting this form, you consent to your data being used as laid out above and in our Privacy Policy.

Where did you hear about Care It Out?

For Office Use Only - Please scroll down and submit your form

FOR OFFICE USE ONLY

Notes

✔ ☐ Videos ☐ Sleep Considerations

Naps

Bedtime Routine

Bedtime Boundary

Stitching sleep cycles

Before you book a Sleep Service with me, I’d love to know:

What's your sleep story?

PLEASE HAVE A QUICK READ OF OUR FAQS BEFORE FILLING THE SLEEP STORY FORM OUT.

The next sleep steps

For Office Use Only - Please scroll down and submit your form

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