Request Form

This form is for Caseworkers, Support Workers and Medical Professionals only. 

Thank you for reaching out to us for support. We appreciate that it can be a difficult thing to do.
  
Baby Give Back is unable to provide direct support to families. We work with caseworkers, social service agencies and health professionals, who are able to assess your individual needs. If you are already connected with a service agency, they can place an order for items on your behalf.
 
If you are not connected with a service agency, you can contact an organisation in your local area or talk to your midwife. For help with family and parenting challenges, you can also contact Family and Child Connect on 13 32 64. Once you are engaged with a service or enrolled in a support program, they can place an order for you and one of our team will be in touch with them directly. 


Please do not click the 'Next Page' button below.

Please ensure you have read the Agency Support page on our website and contact requests@babygiveback.org if you require further information before completing this form. 
Caseworker Information






Please do not use abbreviations here.






Please note: delivery to Logan Hospital is for hospital staff use only
Please note: delivery to Mater Hospital is for hospital staff use only
Please note: delivery to Northern NSW is for flood affected families
After submitting this form, please email requests@babygiveback.org with your order number and delivery address to receive a quote

Family Information



Please include any unborn child/ren

Remember to include the unborn child/ren










Items Required
We supply essential items for children up to the age of 5 years. Please tell us below which items you would like to request for each child in this family. Start with the youngest child (unborn baby if applicable). 



Please select from the date picker or type in format DD/MM/YYYY
This is a starter kit for mother and baby containing newborn nappies,                                       toiletries, breast and maternity pads.  
This is a starter kit for mother and baby containing newborn nappies,                                       toiletries, breast and maternity pads.  



Please select from the date picker or type in format DD/MM/YYYY
This is a starter kit for mother and baby containing newborn nappies,                                      toiletries, breast and maternity pads.  
This is a starter kit for mother and baby containing newborn nappies,                                       toiletries, breast and maternity pads.  



Please select from the date picker or type in format DD/MM/YYYY
This is a starter kit for mother and baby containing newborn nappies,                                      toiletries, breast and maternity pads.  
This is a starter kit for mother and baby containing newborn nappies,                                       toiletries, breast and maternity pads.  



Please select from the date picker or type in format DD/MM/YYYY
This is a starter kit for mother and baby containing newborn nappies,                                      toiletries, breast and maternity pads.  
This is a starter kit for mother and baby containing newborn nappies,                                       toiletries, breast and maternity pads.  



Please select from the date picker or type in format DD/MM/YYYY
This is a starter kit for mother and baby containing newborn nappies,                                       toiletries, breast and maternity pads.  
This is a starter kit for mother and baby containing newborn nappies,                                       toiletries, breast and maternity pads.  
We are experiencing low levels of donated Sleep Spaces, Car Seats and Prams. Given this, we are limiting requests for these large items to one per family.
Please comment below if you are requesting a large item for this family, and include important details including the age of the child. Note: This does not mean we will have items available to meet your request.
Other Items
We have removed the ability to request other items at this time so that we can focus on meeting the needs of families within the categories listed above. 
Reminder: You have selected to have this order delivered to you at your cost - after submitting this form, please email requests@babygiveback.org with your order number and delivery address to receive a quote. 
Please ensure you have entered all information correctly.  
We are supporting hundreds of families each month and prioritise requests based on the information you provide. 

If you have any updates on the family's circumstances or receive items for this family from any other organisation, please let us know as soon as possible on the email below:

Email: requests@babygiveback.org
By submitting this form you agree to our Privacy Policy and consent to us providing details of your request to a third party for the purpose of securing donations of items or funding.