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 read the Agency Support page on our website and contact requests@babygiveback.org for further information. 

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 nappies, toiletries,                                      breast and maternity pads.  

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 
This is a starter kit for mother and baby containing nappies, toiletries,                                      breast and maternity pads.  

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 



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

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 
This is a starter kit for mother and baby containing nappies, toiletries,                                      breast and maternity pads.  

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 



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

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 
This is a starter kit for mother and baby containing nappies, toiletries,                                      breast and maternity pads.  

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 



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

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 
This is a starter kit for mother and baby containing nappies, toiletries,                                      breast and maternity pads.  

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 



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

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 
This is a starter kit for mother and baby containing nappies, toiletries,                                      breast and maternity pads.  

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 

 

Note: We do our best to meet the safety needs of families but we'll be in touch with you to confirm if large items are available for this family. 
Other Essentials or Further Detail

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. We welcome any conversations about brokerage or funding, please contact us 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.