CONI Coordinator Notification of Non-Participation

It is important for us to record as accurately as possible the number of families who decline CONI, or are supported by the CONI programme but do not wish their details to be shared with The Lullaby Trust

Please use this form to notify us of families who are eligible to receive CONI support but

• decide against using the programme or

• who enrol on CONI but decline consent for details to be shared with the Lullaby Trust
Local Coordinator ID
(If you don't remember your ID you can email the CONI Team at coni@lullabytrust.org.uk)
Employer*
If other, please specify
Baby's/Parent's details
Baby's month and year of birth/EDD*
Where does the mother live?
County*
If other, please specify
Postcode*
Reason for offering the CONI Programme?*
If other, please specify
Family are enrolled but do not wish information to be shared with the Lullaby Trust*
- Yes
- No
Parents have decided against using CONI*
- Yes
- No
If yes, please specify reason
Todays date*

DD
MM
YYYY
You can change the way you hear from The Lullaby Trust at any time by emailing coni@lullabytrust.org.uk or calling 020 7802 3200
For information about how we collect, use and look after your details, please read our Privacy Policy

Baby's/Parent's details