BOOKING FORM

If you have read through our website or given us a call and would like to book us to come and visit you, please fill in the following form. Once received we will call to confirm and arrange an exact time for our visit.

This booking form includes some 'Risk assesment' questions which are required for any home visits.

If you simply don't have the time to fill this form in (maybe there is a screaming baby on your lap!) simply fill out the short form on the contact page or call us on 9526 2377.

Your Name

Your Baby's Name

Your Baby's DOB

Your Telephone Number

Your Home Address

Email Address

The service you are interested in is...

Service description on Our Services page

Preferred day / date and time you would like your visit?

What suburb are you located in?

The following next few questions are for 'Risk Assessment of a home location.' - Is the house no. visible from the road?

Yes

Is the home in an isolated/remote area?

Yes

Nearest cross streets and landmarks:

How do we access your home e.g.: stairs, lift, entry door location, security gate, fences, and deadlocks?

How will we let you know when we have arrived e.g. intercom, doorbells, knocking on the door?

Where will the staff member park?

Who else will be in the home at the time of the visit?

If you have weapons on your property are the stored according to state regulations?

Are there family pets? (If yes, please detail)

Language spoken: