1. Your Child(ren):
Are you currently pregnant/expecting a child?
No Skip To Section 2 Yes Yes, twins Yes, triplets If YES, please fill in the details below. If not, skip to section 2
Sex of child/children (if known):
N/A Not yet known Boy Girl Both Estimated due date:
Are you planning to use cloth nappies immediately from birth?
Yes Yes - Once I get home No from 10lbs to skip newborn size No after a few months Undecided Is your child likely to go to childcare/daycare while still in nappies (under 2 1/2 years old)?
Under 6 months 6-12 months 12-24 months 2 years+ Never What type of childcare / daycare?
Nursery Nanny Childminder Relative or friend Only occasional baby sitting How do you/your partner intend feeding your baby in the first few months?
N/A Breast Bottle Mixed 2 Children presently in nappies:
Do you presently have children in nappies who you are considering real nappies for?
No Yes, one Yes, two Yes, more If YES, please fill in the details below. If not, skip to section 2.3
Sex (child 1):
N/A Boy Girl Age (child 1):
Approx weight (child 1):
Please specify lbs or kg
Body shape (child 1):
N/A Very chubby Chubby Average Slim Very slim Height (child 1):
N/A Very Tall Tall Average Short Very Short Is your child prone to nappy leaks of poo? (child 1):
N/A Not prone Sometimes Day time only Night time only Often Is your child prone to nappy leaks of wee? (child 1):
N/A Not prone Sometimes Day time only Night time only Often Is your child likely to go to childcare/daycare whilst still in nappies (child 1)?
N/A Under 6 months 6-12 months 12-24 months 2 years+ Never What type of childcare/daycare (child 1)?
N/A Nursery Nanny Occasional baby sitting Childminder Relative or friend What kind of nappies does the child use at the moment (child 1)?
Sex (child 2):
Boy Girl Age (child 2):
Approx weight (child 2):
Body shape (child 2):
N/A Very chubby Chubby Average Slim Very Slim Height (child 2):
N/A Very tall Tall Average Short Very short Is your child prone to nappy leaks of poo? (child 2):
N/A Not prone Sometimes Day time only Night time only Often Is your child prone to nappy leaks of wee? (child 2):
N/A Not prone Sometimes Day time only Night time only Often Is your child likely to go to childcare/daycare whilst still in nappies (child 2)?
N/A Under 6 months 6-12 months 12-24 months 2 years+ Never What type of childcare/daycare (child 2)?
N/A Nursery Nanny Occasional baby sitting Childminder Relative or friend What kind of nappies does the child use at the moment (child 2)?
2.3 Other details concerning your children :
Are you planning more children later?
No Yes Not sure Do you expect to have more than one child in nappies at the same time?
No Yes Probably Possibly Unlikely Not sure As a guide to the build of your child, please enter:
The approximate height of mother:
The approximate height of father:
Is there any history of significant skin sensitivity/eczema in the immediate family (parents/siblings)?
No Yes If yes, please give details:
3. Your Laundry Facilities :
Do you have a washing machine?
Yes No If no, how do you do your usual laundry?
Do you have a tumble dryer?
Yes No How often do you use your tumble dryer:
N/A Frequently used Occasional use Emergency use only What other drying facilities do you have? (select all that apply):
Outside Line Airing Cupboard Drying/Utility Room Heated Airer Ceiling Airer/Hanging airers/Free standing Airers Aga or Similar Conservatory Radiators Washer/Dryer combined Other If Other, please specify:
Roughly, how often do you plan to do a nappy wash?
Daily Alternate days (recommended) Other Please suggest 4. About Nappies :
How supportive is your partner about real nappies?
N/A Very Reasonably Willing to be convinced Against My responsibility What are your reasons for considering/using cloth nappies? Please rank the following 1 to 5 (1 being the most important.):
Concern about chemicals in disposables:
Financial savings of cloth nappies:
Environmental impact of disposables:
Natural fabrics next to baby's skin:
Baby's comfort/health:
To help me make the best recommendation for you, please score each of the following nappy needs from 1-10 (1 being the most important) Please do not use the same number more than once:
Upfront cost:
Drying speed:
Ease of use:
Slim Fitting:
Looks:
Natural Fabrics:
Change speed:
Reliability / No leaks:
Organic real nappies:
Other - Please specify:
Are you looking for nappies that...:
Fit birth to potty Come in different sizes Open to either option Do you have a nappy budget in mind?
Yes No Not sure If yes, what budget are you aiming towards?
5. Your Details :
First Name:
Surname:
*
Email Address:
*
Confirm Email Address:
6. Finally :
Please provide any further information which you think may be relevant, including any thoughts you may have had about suitable nappies or details of those you have previously tried:
*
Where did you find out about The Nappy Lady's advice service ?
- Facebook Group -Please Specify Below Facebook Advert Friend Family Health Professional Previous User Nappy Library Nappy Lady Staff Recommended Read about service on The Nappy Lady website Mamalina Telegraph Article Mumsnet Baby Centre Instagram Google Search Local Council Other Please Specify Below Facebook Other Please Specify:
*
Please add the two numbers
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