Request form

Thanks for visiting Eureka Mums!

To access our services all caseworkers, social workers and maternal and child health nurses must be registered with Eureka Mums. If you are not yet registered, please register here prior to completing this form.

Please complete one form for each family you are requesting for, unless you are placing an order for bulk stock. In this instance, please add "bulk stock" in the "mother's or primary carers name" field.

For helpful hints on how to complete this form please click here.

For further assistance or for emergency requests, please contact the Social Services Coordinator via email

We look forward to receiving your request soon - thank you for your support of families in need.

Your Details

example: 0400111333

Family Information

Items Required

Cot or bassinet: Please note that cots are recommended from birth, and bassinets only last until the baby can roll, which can be as young as 10 weeks

If the family has a cot in good condition that complies with the current regulation and only needs a mattress, please enter 1 here specify the details of the cot on notes and specify the required mattress size here (length, width and height). You should find these measurements on the base of the cot.

Size Boy Girl
UniPrem:
Prem
0-6 m
6-12 m
1-2
2-3
3-4
5-6
7-8
9-10
11-12
13-14
15-16
 Size   Boy  Girl
C5
C6
C7
C8
C9
C10
C11
C12
C13
Y1
Y2
Y3
Y4
Y5
Y6
Y7
 Size   Boy  Girl Unisex
Bassinet
Cot
Single Bed

Opening Times

Our opening hours for collections are: Tuesday and Thursdays 10am - 12pm.

Criteria for collection:

  • Pick up must be at least 5 business days from date of order. This is to give us enough time to prepare stock for you.
  • Clients must be 6 months or 28 weeks pregnant to book a pick up date. If you are ordering before your client is 28 weeks pregnant you will need to email us closer to the due date to schedule collection. We will also send you a reminder.
Looking forward to receiving your request soon - thank you for your support of families in need.