Baby & Toddler Sleep Assessment
Please complete this assessment to help me understand your child's sleep habits and how I can support your family's sleep goals. Expect your assessment results in 1-3 business days - this is not an instant result and instead is completely custom to your child and I need time to review this! I may need you to answer a few more questions so keep an eye out in your inbox!
Your Full Name
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First Name
Last Name
Email Address
*
example@example.com
Location or Nearest City
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Child's Name
Child's Date of Birth
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Day
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Month
Year
Date
Please write your child's current sleep schedule. Wake up time, nap times & bedtime...
Breast, bottle, formula or mix fed?
How many milk feeds per day and roughly what times/how often?
How many milk feeds per day and roughly what times/how often?
Any previous medical history?
How many naps does your child take per day and rough duration?
How often does your child sleep? Are you following any wake windows?
What is your child's current bedtime?
Hour Minutes
AM
PM
AM/PM Option
What time does your child typically wake up?
Hour Minutes
AM
PM
AM/PM Option
Describe your child's bedtime routine
How do you get your child to sleep? Go into as much detail as possible
What sleep aids do you use? Dummy, comforter, white noise etc.
How many times does your child wake through the night? Roughly what times?
What do you currently do during night waking?
Where does your child sleep? Bed sharing, bassinet in parent's room, cot in own room etc.
Is your goal to get them sleeping in their own cot or bed? Continue bed sharing etc.
Do you know the temperature of their sleep space?
What do you currently dress your child in for day sleeps and night sleeps?
What are the main sleep challenges you are experiencing? (Select all that apply)
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Frequent night wakings
Difficulty falling asleep
Short naps
Early morning waking
Needs to be rocked/nursed to sleep
Other
If you can, write down how a typical day of sleep looks...
What are the difficulties you are facing? What areas of your child's sleep are you hoping to improve?
Is there anything else you think would be great for me to know?
Submit Assessment
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