Trafford Sleep Services Webinar Booking Contact Details Child Date of Birth About your child - Diagnosis Does your child have a diagnosis of autism? YesNo Does your child have ADHD? YesNo Is your child on the diagnostic pathway? YesNo Does your child have a physical difficulty or disability? YesNo Does your child have a learning difficulty or disability? YesNo Does your child have a Social, Emotional, Mental Health difficulty? YesNo Other diagnosis or difficulties: Please tell us about your child - Sleep Difficulties My child has difficulty settling to sleep? YesNo My child wakes up in the night? YesNo My child has nightmares? YesNo My child has sleep terrors? YesNo My child wakes up early in the morning? YesNo Other sleep difficulty, please specify: Webinar - please select which one to attend Primary: for parents or carers of children aged 2 to 11 years. Secondary: for parents or carers of children aged 11 to 18 years. PrimarySecondary How did you hear about this service? Word of mouthPaediatricianCAMHSOther Health ProfessionalEarly Help or Family Support WorkerSchoolTrafford DirectoryOther Reason Other reason, please state: GDPR: I agree to Sleep and Therapy Services processing my data for the provision of sleep services. Privacy notice is available at the bottom of the website. I agree Contact us Get in touch Working together to transform children’s lives through Sleep and Therapy Services Email Address Trafford@sleepandtherapyservices.co.uk Email Phone number +44 7838110985 (Please get in touch by email as we are not always contactable by phone) Phone
