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New Client Information Form

Slumberland Solutions
New Client Information

Please take a moment to fill out the form.

First Name

Email

Baby Name

Last Name

Phone

Baby Birth Date

What is your baby's current daytime sleep schedule? (Wake time, feedings, activities, bedtime)

What is your baby's bedtime routine?

How many total hours does your baby sleep? (Include daytime naps and night time sleep)

Does your baby use a sleep prop and/or pacifier to go to sleep or fall back to sleep in the middle of the night?

Have you tried any other sleep training methods or programs? Please list:

Please add any additional information you would like us to know about your baby.

How did you hear about Slumberland Solutions?

Thanks for submitting! We'll reach out to you soon.

contact

Contact Info

Tel: 914-391-8949

Email: carla@slumberlandsolutions.com

Slumberland Solutions

© 2024 by Slumberland Solutions

Carla Perl
Certified Pediatric Sleep Consultant
Certified Positive Encouragement Educator

Disclaimer:

The information/advice provided during this consultation is not medical advice. Reliance on the advice is solely at your own risk. The advice is for informational purposes only and is intended for use with common sleep issues that are unrelated to medical conditions. The information provided is not intended nor is implied to be a substitute for professional medical advice. Always seek the advice of your physician with any questions you may have regarding a medical condition or the health and welfare of your baby, and before following the advice or using the techniques offered in this consultation. Also, it is always best to follow sleep recommendations according to the SIDS campaign. In no event will Carla Perl or Slumberland Solutions be liable to you for any claims, losses, injury or damages as a result of reliance on the information provided.

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