INTRODUCTION Distributors of the Pepi-Pod® sleep space programme need to be registered. This is a quality process to ensure a standard is upheld and acknowledged in the distribution of the programme. It is a mechanism for accountability to families, funders and coroners, and is offered as support for participating agencies.
THIS FORM This form is to be completed by the person leading the programme in your DHB, or your agency, if not a DHB. A unique registration number will be issued to each person that you confirm has met the competency standard as evidence of this. The registration number is recorded on distribution forms each time information is collected from families.
Thank you. Stephanie Cowan, Programme Director, The Pepi-Pod® Programme (June 2014)
Name of the DHB region of your service:
Your DHB or Agency has a signed Participation Agreement with Change for our Children Limited for providing the Pepi-Pod® programme:
Name and email of the Programme Coordinator completing this form and certifying the competence of distributors.
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