Start Sleeping

Toddler Sleeping

Welcome to our intake form. If you’re ready to get started, you’re on the right page. After you’ve learned about Sleep Sisters, please review our services page and take a look at our packages and rates. Then, answer the questions below (or print out the PDF and email it to us) so we can get started. Please be as honest and open as possible. We’re not here to judge…sleep training is hard work and we’re here to help! The more we know, the better we can help get your family back to sleep. And if you have any questions, don’t hesitate to contact us.

Your Name (required):

Your Email (required):

Parent's Names:

Child's Name:

Child's Date of Birth (mm/dd/yyyy):

Child's Due-date if he/she was early:

What are your goals for our work together?

What package are you interested in?

Child's Sleep time at night:

Is your child waking at night for feedings? If so, at what times and for how long is he/she awake?

Is your child waking at night for any other reasons?

Child's wake time in the morning:

Is your child still napping? If so, times of naps and wakings:

Where does your child sleep for naps and at night? Briefly describe the sleep environment.

Is your child in child-care outside of your home?

Does your child mouth breathe? Snore? Have any medical conditions?

Please share with us a brief history of your child's sleep routines and include any 'extras' you're using (like a pacifier, swing, stroller...etc.):

Is there anything else going on in your home (with the environment or family relationships) that you think might be affecting your child's sleep?

In brief, how would you describe your parenting styles (i.e. attachment, go-with-the-flow, scheduled...etc)?

Additional Notes:

How did you find out about us?

GoogleYahooBingFacebookEmbraceHerReferralOther

If other, who referred you?

What is your phone number?

For video chat, what is your Skype, Google Chat, Facetime or other video chatting service information? Please list your preferred service and your username so we can find you.

What is your physical/mailing address?

Please upload a photo of your child or your family if you like!

Would you rather fill out a PDF form and email it in? Here’s a link to one. Just click and your download will begin!