Sleep Coaching: Intake Info & Consent

This form is for sharing standard contact information, consent for us to work together & GDRP info. Due to it's identifying nature is kept separate to the main Questionnaire for privacy reasons.

    Please note that I keep your information in a password protected environment, and I keep your identifiable information separate to that of the questionnaire and notes. Any documents that I send to you, I will send password protected. The password will be your child’s date of birth, for example if born on the 15th December 2019, the password would be 15122019. By replying by email, text, WhatsApp, Messenger etc, you are doing so on the understanding that I cannot encrypt or lock away, other than my electronics are always password protected and kept either locked within my home or securely with me when out and about. By messaging me by other means, you are automatically granting me permission to save your number, email address and to respond via that service.
  • This field is for validation purposes and should be left unchanged.