Informed Consent

Your child’s safety and well-being come first. Before beginning any sleep consultation, we provide clear information about our services, methods, and what to expect. By participating, you acknowledge that you understand the guidance provided and agree to follow the recommended plan for your child.

Informed Consent Form

DreamBird Sleep Consulting, LLC – Informed Consent for Services

Dr. Marissa Barash

marissa@dreambirdsleepconsulting.com

Certified Infant and Toddler Sleep Consultant

Licensed Psychologist

DreamBird Sleep Consulting provides pediatric sleep consulting and parent coaching services. Services are informed by evidence-based sleep education and behavioral strategies commonly taught through the Institute of Pediatric Sleep and Parenting (IPSP).

DreamBird Sleep Consulting, LLC does not provide psychological services and does not constitute psychotherapy, counseling, psychological assessment, diagnosis, or treatment of mental health conditions.

Nature of Services

Sleep consulting services are educational and coaching-based in nature and focus on: - Infant, toddler, and child sleep education - Sleep schedules, routines, and sleep hygiene - Behavioral sleep strategies - Parent coaching and support related specifically to sleep. Services are not medical or mental health treatment and are not a substitute for care from a licensed physician or mental health provider.

Mode of Service Delivery (Virtual-Only)

All services are provided virtually only, including: - Phone or video consultations - Email communication -Written sleep plans and educational materials. No in-person services are offered. Clients are responsible for ensuring a private, secure environment during consultations and for maintaining the confidentiality of electronic communications on their end.

Scope and Limitations

Sleep consulting does not include: - Diagnosis or treatment of mental health disorders - Psychotherapy or counseling - Crisis intervention - Assessment of developmental, psychiatric, or medical conditions. If concerns arise that fall outside the scope of sleep consulting (e.g., significant mental health, medical, or developmental concerns), the provider may recommend that the client seek care from an appropriate licensed professional. DreamBird Sleep Consulting, LLC does not provide mental health treatment.

Client Responsibilities

Clients agree to: - Provide accurate and complete information - Inform the provider of relevant medical or developmental issues that may impact sleep - Consult their child’s pediatrician regarding medical concerns and feeding recommendations (prior to starting consults)-Understand that outcomes vary and sleep improvement cannot be guaranteed. No Emergency Services: DreamBird Sleep Consulting does not provide emergency or crisis services. In case of emergency, clients should contact 911, go to the nearest emergency room, or contact an appropriate crisis service.

Use of Provided Guidance

All sleep plans, tips, and guidance provided by DreamBird Sleep Consulting, LLC are for your family only. They may not be shared, redistributed, or given to other families without explicit permission. This ensures that recommendations remain tailored, safe, and confidential for your child.

Confidentiality

Information shared during sleep consulting is kept confidential to the extent possible, but is not protected by psychotherapy confidentiality laws or HIPAA in the same manner as mental health treatment.

Consent and Acknowledgment

By signing below, the client acknowledges that they understand: - Sleep consulting is educational and coaching-based - Services are virtual-only - Services are not psychotherapy or mental health treatment -Participation is voluntary

Client Name: ________________

Signature: _________________

Date: _______