Partners

Cribs for Kids Partners Page

Referral Form: Use ONE

• COVID-19 Precaution Protocol
• Prenatal Referral Form (PDF) / (Spanish Version) (PDF) / (French Version) (PDF) OR
• Postpartum Referral Form (PDF) / (Spanish Version) (PDF) / (French Version) (PDF)

  
  

After Health Department approval and crib is delivered, use all the following forms at home visit:

• Checklist (PDF) / (Spanish Version) (PDF) / (French Version) (PDF)
• Cribs for Kids Hold Harmless Agreement (PDF) / (Spanish Version) (PDF) / (French Version (PDF))
• Safe Sleep Questionnaire (PDF)
• Guidelines for Parents and Caregivers (PDF) / (Spanish Version) (PDF) / (French Version) (PDF)
• About Your Graco Pack n’ Play (PDF) / (Spanish Version) (PDF) / (French Version) (PDF)
• About Your Cribette (PDF) / (Spanish Version) (PDF) / (French Version) (PDF)
• Contact Information Form (PDF) /(Spanish Version) (PDF) / (French Version) (PDF)

3 Month follow-up Questionnaire:

• Safe Sleep Follow-Up Questionnaire (PDF)

Supplemental/supporting information for home visits:

• National Cribs for Kids Animated Airpipe video
• How Safe Sleep Savvy Are You? This is a short video quiz that can be used by providers to engage caregivers in conversations about safe sleep recommendations. Click Here
• Safe Sleep for Babies PowerPoint—English (PDF)
• Safe Sleep For Babies PowerPoint--Spanish (PDF)
• Why Back Sleep Position is Best (PDF)
• Triple Risk Model (PDF)

How to Set up your Cribette