Preliminary Questionnaire (Lite Support Plan)

Your answers to the following questions will help me better customize your child's sleep plan. If you would like to revise your answers before submitting, please hit "save" and return to complete it when you're ready. Please allow two business days to receive your sleep plan. (Sleeping Well Consulting is open Monday through Friday, with the exception of U.S. public holidays). Thank you so much, and here are the questions:


That's all the questions, thank you! Next, please tick the box for your client agreement, and remit payment. I look forward to receiving this information from you so I can get started writing your customized sleep plan!

Please read over the following client agreement and tick the box above that you accept the terms and conditions of this agreement.

By ticking the box, you acknowledge that I will provide you with a plan that is as gentle as possible, and allows you to stay with your child, if preferred, but that crying can not be prevented if your child's emotional response to a change in his/her sleep process is to cry. I will provide you with options to soothe, comfort, reassure and support your child, but please understand that crying is a symptom of frustration, confusion, and often fatigue and as such may not be prevented.


Payment is due upon receipt of your invoice, and without it, I won’t be able to write your sleep plan.

Commit to the plan. It works! Have faith that what we’ve agreed upon will work and stick to it long enough to see the result.

If you don't follow ALL of the plan you can't expect to achieve full results.


To put your child first. Our entire plan will be created to benefit of your child. I will ask you to make changes and I will educate you on how your decisions and actions impact your child’s sleep.

Please understand that I can provide you with multiple options, but that if you don't want to do any of the steps required to initiate change that a refund will not be offered, as I have indeed provided you with my time and expert knowledge as promised.

To be available to you for our appointment(s). I avoid rescheduling calls because I know what it’s like to be anxious for support. In return, I hope that my clients will stick to our arrangements as well out of respect of the other families that I work with.

To be patient. I know you’re sleep deprived and you’re doing the best you can. I don’t judge any of your decisions up to this point, and I respect you for investing in your child’s sleep health.

To support you the best I can. Implementing change is hard! I’m here if you need to vent, cry or talk something through.

To abide by the follow-up guidelines that I’ve provided to you. We will mutually schedule our phone calls and I will reply to your emails or texts as soon as I can (often immediately!) but if anything, within 24 business hours.

Follow-Up Guidelines -- How The Support Part of Your Plan Works:

Your package includes one check-in call to be used within 6 months of receiving your sleep plan. Here is the link to book a Check-In Call.
Your package also includes one email consultation to be used within 6 months of receiving your sleep plan. Email me: [email protected] with your questions and I will respond within 24 business hours.
If you don't receive a response within 24 business hours, please send a follow-up email.
Business hours are Monday through Friday, 8:00 a.m. to 5:00 p.m. (unless other arrangements have been made for bedtime, overnight or half-night consultations).
Sleeping Well Consulting is closed on all public holidays.

My Services Are Not Medical Advice. The advice you receive from me is for informational purposes only and is intended for use with common early childhood sleep issues that are wholly unrelated to medical conditions. The early childhood sleep issues that I work with are related to behavioral conditions related to habits learned over time. My advice is NOT intended to be a substitute for medical advice or treatment. Always seek the advice of your doctor or other qualified health practitioner regarding any matters that may require medical attention or diagnosis, and before following the advice and using the
techniques described in The Sleep Sense Program.

Kim Rogers does not make any representations or warranties, express or implied, regarding consulting services provided. Kim Roger’s liability (if any) is limited to the consulting fee paid by you to Kim Rogers and in no event will Kim Rogers be liable to you for any other claim, losses or damages.

I have read and understood the commitments outlined above and by signing below agree to the terms of this agreement.


By agreeing to this release form, you agree to be bound by, and to comply with, these Terms and Conditions. If you do not agree to these Terms and Conditions, please do not use tick the box.

PLEASE NOTE: We reserve the right, at our sole discretion, to change, modify or otherwise alter these Terms and Conditions at any time. Unless otherwise indicated, amendments will become effective immediately. Please review these Terms and Conditions periodically.
Price: $ 249.00