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Sleep Consultation for You and Your Family

Our Sleep Consultant will work with you and your family to tailor a plan that fits your parenting approach and individual needs

Sleep Intake Form

For New Clients

Does your child have any medical diagnoses or health concerns? (allergies, asthma, GERD/reflux, colic, etc.)
Does your child snore, sleep with their mouth open, or sweat during the night?
Have you talked to your child's pediatrician about your concerns with your child's sleep?
Please check all of the following sleep difficulties that your child exhibits.
(For infants only) Do you swaddle or put your baby in a sleep sack during sleep?

Thank you for taking the time to complete this form. Our Sleep Consultant will review the information and be in touch with you as soon as possible.

Thanks for submitting!

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