The Baby Nurse Registration Form 2025
Please complete the following form so I can know how to help you. I aim to respond within 24 hours.
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Today's Date *
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Your Name *
Your contact phone number *
Address *
Please include street, suburb and city
Your email address *
If you have a gift certificate please put the reference code below
How did you hear about The Baby Nurse? *
Who is your Lead Maternity Carer (midwife/Specialist) *
Who is your GP? *
GP Phone Number
Partner or Support Person's Name *
Partner or Support Person's phone number *
Partner's Ethnicity *
Required
YOUR DETAILS AND HEALTH HISTORY (Mother)
Date of Birth *
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YYYY
Ethnicity *
Required
YOUR HEALTH HISTORY *
Please tick any that apply to you
Required
What is the main reason you contacted The Baby Nurse? *
Required
PRESENTING PROBLEMS
Tick all that apply *
Required
INFORMATION ABOUT YOUR BABY
Name *
Gender *
Date of Birth *
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What number baby is this? *
Issues affecting your baby
Tick all that apply *
Required
Anything else you need to tell me about your baby?
Do you have private health insurance?
Are you a WINZ Client?
The Fine Print - Pricing
Thanks so much for getting in touch! I'm really looking forward to working with you.

An initial consultation involves taking a comprehensive history, assessment, observation of a feed (if the issue is feeding related), and making a plan. It is helpful to have a hungry baby for the consultation time if you are wanting feeding help. This consultation generally takes around 1.5 hours.

Cost for an initial appointment is $175.00 (home visit within my usual catchment area - see website for map).

Follow up consultations take up to one hour. Cost is $130 (home visit within my usual catchment area)

Payment is expected on the day of your consultation via internet bank transfer, eftpos or by cash. Note: For virtual appointments, payment is expected prior to your consultation. If you need to cancel or change your appointment, please advise me at least 24 hours prior to your appointment. Failure to do so may incur a $30 cancellation fee.
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