If you need any help with this form, you can call us on 0808 800 3333.
You must answer all the questions marked with an asterisk (*).
Sleep Right may not be suitable for you. If you’d like to discuss this with us, please complete this application and we'll contact you.
Sleep Right is for parents of disabled children or children with additional needs. Your child does not need to have a medical diagnosis. If you’d like to discuss this you can either call us on 0808 801 0510 or complete this application and we'll contact you.
To get a referral in Northamptonshire and Peterborough please contact firstname.lastname@example.org.
Sleep Right is only available in London, Leeds, Northamptonshire and Peterborough. You can find advice about helping your child to sleep on our website.
You can also call our helpline for advice on 0808 800 3333.
To use this service we’d like to contact you by phone and by email before arranging a face to face meeting. Please tell us if you have any access requirements.
We will not use your details for marketing or fundraising.