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The Sleep Works

Gentle sleep solutions for babies, children and adults

Book Your Free Initial 15-Minute Phone Chat

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Child Sleep Questionnaire

Step 1 of 6

16%
  • Parent 1 (You)

  • Parent 2

  • Other members of your household

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  • History

    1. Prenatal

  • 4. The following three questions are for Mum

  • Your Doctor's Details

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  • Development and Health History

    1. Approximately when did your child reach the following milestones (where applicable)?

  • 2. Feeding

  • 4. Does your child:

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  • Sleep Habits

  • Schedule

  • Please include feeding amounts, breastfeed vs bottle if you do both, and times fed. Also include what you do to try to help your child settle to sleep.
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  • Other Questions

  • 3. Answer the following questions a) to h) only if they weren't covered in your responses to the 'Schedule' question on the previous page.

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  • Sleep Consultant Contract & Letter of Agreement

    As Sleep Consultants, we are dedicated to help you improve your child’s sleep. This letter is our agreement regarding our services. We agree to the following:

    Our Services: Following a free preliminary phone conversation to discuss your child’s current sleep situation and options for how we can help, we will send you an email with a link to the Sleep Questionnaire to complete online, including an overview of your child’s current sleep situation over a 24-hour period, and this Letter of Agreement for your e-signature.

    Following submission of the completed questionnaire to us, you can go to our website to book a consultation date. Please allow at least 3 days after submission of your questionnaire for the consultation date, in order to enable us to process the questionnaire and adequately prepare for our consultation.

    During the consultation, we will discuss this background information; we will explain sleep basics and the specific areas of your child’s sleep to focus on, tips and suggestions flagged up from the questionnaire and our discussions, suggested framework for your child’s day, and options for sleep training approaches. We will answer any questions you have, and together we will create a plan to improve your child’s sleep. After the consultation, a copy of the sleep plan will be sent to you by email.

    After the initial consultation, we offer either a package with 1 follow-up call, or a package of unlimited follow-up support by email and phone as you progress through the plan (for up to 2 months). During these follow-ups, we will review how the plan is progressing and discuss possible tweaks to it, if necessary.

    1. Your Role: You agree to the following participation in order for the Sleep Plan to be effective:

    • Keep a sleep/wake log during the weeks we are working together.
    • Carry out the steps in the Sleep Plan that we have developed together consistently.
    • Communicate openly with me with any questions or concerns you have about your child’s sleep, including any medical, health, or emotional situations that may arise.
    • Discuss your experiences during the plan, so we can make necessary adjustments.
    • Dedicate approximately 3 weeks to sleep training without travelling or any major family or work events and make your child’s sleep a priority during that time.

    You acknowledge and understand that the effectiveness of sleep coaching depends on your consistent follow-through, both during and after our work together, although there can never be a 100% guarantee of success.

    2. Fees: Our fee structure offers the choice between a Consultation + 1 follow-up call (Standard Package) or Consultation + follow-up support (Plus Package).

    Child Sleep Standard Package: £200 (for 1 child; please contact us for details of packages for 2 or more children)

    • Review of Sleep Questionnaire and Sleep Logs (submitted prior to consultation).
    • 1½ - 2 hour consultation by Skype or Facetime with a camera (or in-home, depending on location.
    • Discussion of sleep basics, your questions, and the challenges you and your child faces.
    • The creation of a detailed, individualised sleep plan tailored to your goals and needs.
    • 1 follow-up call during the sleep plan.

    Child Sleep Plus Package: £300 (for 1 child; please contact us for details of packages for 2 or more children)

    As above plus:

    • Follow-up support calls or emails for up to 2 months. Individual calls after this will cost £25 for half an hour.

    Please note: The success of Sleep Coaching will depend on your ability to be consistent while following your Sleep Plan. The support offered to you during the follow-up calls and emails is usually invaluable and highly recommended, will make the Sleep Coaching more effective, and will help ease the process for you and your partner.

    3. Payment Method and Expenses: Fees are to be paid before the consultation by bank transfer. For face-to-face consultations, we will also accept cash.

    4. Contacting us for follow-up sessions: We will correspond by email, WhatsApp or text and will schedule in phone calls at specific, mutually convenient times. We are generally available between 9am-2pm, some mid-week evenings, and at limited times over the weekend.

    5. Cancellations: If you need to cancel or reschedule your consultation, please notify us as soon as possible so that we can offer your appointment to another tired family.

    6. Insurance: Regrettably, we are unable to accept insurance proceeds. You may however submit our invoices to your insurance company, but we cannot guarantee reimbursement for our fees or for any expenses you may incur during the coaching.

    7. Confidentiality: We will keep all information we share confidential. You understand there are circumstances that may require us to disclose information (for example, by law or pursuant to a court order). If that occurs, we shall be released from this obligation, but only to the extent of the information we are required to disclose.

    8. Our services are not medical advice: You understand that we are not medical professionals and will not advise you on medical conditions, or make medical diagnoses. You also understand that your child’s sleep patterns or sleep difficulties may be symptomatic of a condition for which medical intervention or treatment is advisable. If you have any reason to believe that your child’s sleep difficulties may be related to a medical condition, or that your child has health concerns that may be adversely affected by sleep coaching, it is strongly advised to consult with your child’s doctor before beginning the sleep coaching process. You are solely responsible for discussing any possible medical conditions with your child’s doctor or other health professional. You understand that you assume primary responsibility for the health of your child and, to the extent permitted by law, you will not hold us or our consultancy responsible for any outcomes resulting from complications that are outside of our control.

    9. Disclaimer: To the extent permitted by law, The Sleep Works expressly disclaims any liability, loss, damage, or injury caused by information provided to the client.

    10. Entire Agreement: This letter reflects the entire understanding between us and may only be changed in writing, signed by both of us. If a court decides any of the terms are unenforceable, we agree that these terms will be severable from the agreement and all other terms of our agreement will remain in effect.

    11. Termination: This agreement will terminate automatically upon completion of the services required by this Letter of Agreement.

    Please acknowledge your agreement and understanding of these terms by signing below. We look forward to helping you and your family to make a gentle transition to a restful night’s sleep for you and your child.

    Yours sincerely,

    Maryanne Taylor's signature

    Maryanne Taylor
    Founder and Sleep Consultant, The Sleep Works

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