Parenting Foundations Membership It is nice to have you here!! Tell me a little more about you… Step 1 of 9 11% What is your first name?* What is your last name?* What are the names of other parent/guardian(s) of your child(ren)? How many children do you have?*Please enter a number from 0 to 6.First Child's Name* First Last First Child's Birthdate* MM slash DD slash YYYY Second Child's Name First Last Second Child's Birthdate MM slash DD slash YYYY Third Child's Name First Last Third Child's Birthdate MM slash DD slash YYYY PhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Please describe the main reason you became a member of Parenting Foundations.* Sleep Related QuestionsThis part of the questionnaire will help Brenda understand if there are any concerns regarding your child's sleep. Please fill this out even if you are just wanting behavior or parenting.How much sleep does your child get in total? This includes daytime and night time sleep. How much sleep does your child get overnight?* How many naps does your child take on an average day?*Please enter a number from 0 to 6. What time is bedtime?* What does bedtime routine look like?*What happens during the night? Please describe your best nights and worst nights.* Behaviour Related QuestionsPlease complete this part of the questionnaire if you are questions regarding your child's behaviour.Please describe your child's behaviour that you would like to discuss.How do you typically respond to this behaviour? Final QuestionsHow do you best describe your parenting style?Does your child have any medical conditions?* Yes No If you answered yes to the above question please explain the medical condition.Please tell me 3 wonderful things about your child! Thank You!Thank you for taking the time to complete this form. This form will help me understand how I can best help you! After pushing the submit button you will be brought to the Members Dashboard. I look forward to working with you and I welcome you to our wonderful community of support.NameThis field is for validation purposes and should be left unchanged. Δ ShareTweetSharePin0 Shares