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Welcome to The Public Health Notebook’s Safe Sleep Requests Form, a part of our partnership with the Cuyahoga County Board of Health Cribs for Kids Program.

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This form is designed to help families in need of a safe sleep environment for their baby. By completing this form, you can request a Pack ‘n Play and receive valuable information about safe sleep practices to help ensure your child’s health and safety.

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Who is eligible?

  • Families with infants or expectant parents in need of a safe sleep space.

  • Families that live within Cuyahoga County

  • Mother of the child is at least 32 weeks

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What will you receive?

  • A Pack ‘n Play to create a safe and secure sleep area for your baby.

  • Resources and education on best practices for safe sleep.

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How does it work?

  1. Fill out the form below with the requested details.

  2. A team member will review your information and contact you to coordinate delivery or pick-up.

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Let’s work together to provide every baby the safe start they deserve. Thank you for allowing us to support your family!

Are you at least 32 weeks *If you are not at least 32 weeks, you can not receive a pack n play at this time but still complete the form. I will reach out when you are eligible*
Yes
No
Expected Due Date or Child's Date of Birth
Month
Day
Year
Do you currently have a safe sleep space?
Yes
No
Maybe
Do you need information on safe sleep?
Yes
No
Maybe
How did you hear about the Cribs for Kids program?
Community Referral
Social Media
Friend/Family
Other
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