Infant Safe Sleep Initiative

The goal of this initiative is to promote and increase community awareness about infant safe sleep principles and practices through education. Pack N Play kits are provided at no charge to qualifying caregivers who do not have other options for a safe sleep environment for their newborn. This includes caregiver education on the Period of PURPLE Crying, a new way to understand your infant’s crying. To coordinate an appointment, call us at 989-835-9922 or complete the form below.

What is Infant Safe Sleep?

New Child Program Request

Complete the form below to coordinate an infant safe sleep appointment.

Your Name

First Name

Last Name

Email

Phone

(###)

###

####

Referral Agency (If Applicable)

Custodial Caregiver Name

First Name

Last Name

Custodial Caregiver Phone

(###)

###

####

Is family currently receiving benefits from WIC?

Yes

No

Unknown

Is family currently receiving food assistance benefits?

Yes

No

Unknown

Does child live in Midland County, MI?

Yes

No

Child's Name

First Name

Last Name

Child's Date of Birth/Anticipated Due Date

MM

DD

YYYY

Child's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Briefly describe goals you wish to achieve at the appointment.

Infant Safe Sleep Initiative

New Child Program Request

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