What’s your full name?
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First Name
Last Name
How should I address you?
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What is your spouse's/partner's name? How should I address them?
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What's your email?
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What’s your phone number? When is the best time to reach you?
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What’s your preferred method of communicating (email or phone)?
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What's your mailing address?
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
What do you do for a living? Where is your office/workspace?
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Are you currently working from home? What hours do you spend outside the home?
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What is your spouse's/partner's occupation? What are their work hours?
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Is your spouse/partner involved in the daily care of your baby? If so, what are both your roles and responsibilities?
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Is there anyone else (family member/nanny) that helps care of your baby? If so, who and how do they help?
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Now, the best part! Please tell us about your baby. What is your baby –their name and birth date?
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Was your baby full term? If not, what week gestation was your baby born?
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What is their current weight?
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Do you have other children? If so, what’s their name(s) and age(s)?
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If you have other children, what are their current bedtimes, wake times and nap times?
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Does your baby currently have a bedtime schedule? Please share their bedtimes, wake time(s) and total sleeping time.
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Do you have a current bedtime routine? Please describe it for us.
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Where does your little one sleep at night?
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Do you have a current nap schedule and routine?
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How many times a day does your baby nap? What times of day do those naps happen?
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Where does your baby nap?
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Is your baby rocked, held or fed to fall asleep at night time and/or nap time?
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Does your baby share a room with a sibling? Do you plan on having your baby share a room with another sibling at some point?
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Does your baby use a pacifier? If so, when and how often?
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Does your baby have a comfort item (blanket or other item) they love to use?
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Is your baby swaddled?
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Do you use a sound machine?
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Tell me about your baby's sleep environment. For example, do you keep the room dark for sleep times? Is the room kept at a specific temperature?
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Share with us your baby’s feeding habits. Are they breastfed, bottle fed or a combination of both?
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At what time of day/night do you feed your baby?
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Does your baby eat solid food? If so, how many times per day?
Do you have any specific questions or concerns you would like Sleep & Potty Co. to address during your consultation?
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What would be your ideal bedtime and wake times for your baby?
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Are there periods of time during your daily schedule that require you to be somewhere outside of the home that we should take into consideration when creating a schedule for your baby (for example a class you’re taking, or picking up another child after-school, etc.)
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What sleep books, if any, have you read in the past? Were they helpful? Have you previously tried any sleep methods or techniques with your baby? If so, what happened?
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Do you and your family have any general philosophies on sleep?
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Please describe your hopes and goals after consulting with Sleep & Potty Co.
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