Infant Sleep Aid Product Use Questionnaire Form
Please complete this form to help us understand how sleep aid products are used for infants and your experiences with them.
Caregiver Name
*
First Name
Last Name
Caregiver Email
*
example@example.com
Infant Age Range
*
Please Select
0-3 months
4-6 months
7-12 months
13-18 months
19-24 months
Which infant sleep aid product do you use?
*
Please Select
Swaddle
White noise machine
Pacifier
Sleep sack
Soothing night light
Other
How often do you use the sleep aid product?
*
Every night
Most nights
A few times a week
Rarely
Only during naps
When do you typically use the sleep aid product?
*
At bedtime
During naps
During nighttime awakenings
When traveling
Other
What outcome did you observe after using the product?
*
Improved sleep duration
Easier to fall asleep
Fewer awakenings
No noticeable change
Other
Have you noticed any side effects or concerns?
*
No side effects or concerns
Restlessness
Discomfort
Difficulty breathing
Other
Overall, how satisfied are you with the sleep aid product?
*
1
2
3
4
5
Additional comments (optional)
Submit
Should be Empty: