Sleep Nurse


 

Consultation Form

Clear some time when you will not be interrupted, and where you have the time to focus on thoughtfully completing this form. It will take most people about 1 hour to complete. For some it could take longer. I totally get that this request sounds both overwhelming, and a bit insane given how sleep deprived you are!! But the more information you can provide me now, the more time we will have for actual problem solving, and planning later!! Take your time, sit, reflect, and ponder. It may help to do something to relaxing such as drinking some delicious tea (or wine!), or putting on your favourite tunes. Trust me, its worth it 🙂
Example: John Smith (January 23, 2018)
(XXX) XXX-XXXX
Note: a serving of alcohol includes 12oz of beer/cider, or 5oz of wine, or 1.5oz of spirit