Inquire

Primary Caregiver's First and Last name(Required)

Email(Required)

Phone

Child's D.O.B

Does your child nap? If yes, what time and for how long?

Does your child have challenges drinking water, juice, or other liquids? What kind of vessel do they typically drink from?

What kind of vessel does your child typically drink from? (open cup, 360 cup, sippy cup with straw etc.)

If you have previously potty trained another child, kindly share your experience (strategies used, level of difficulty, overall reactions toward the process etc.)

How would you describe your child's diet?

Are your child's bowel movements consistent and easily predictable? How often and what time of the day?

Any history of constipation, stool, or urination withholding? Explain treatment

Does your child have any developmental delays or disabilities?

Have you tried potty training your child before contacting SunRae Solutions? If so, please describe the experience(s).

If you've attempted potty training without success, what do you believe were the greatest barriers? Additionally, what strategies proved successful during the process?

What kind of support are you looking for SunRae Solutions to provide?

Please use this space to provide any other important information your SunRae Expert should know

How did you hear about SunRae Solutions?

Email

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Potty Training Intake Questionnaire

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