Birth Support Evaluation

Help us support you better in the future. By completing the following evaluation, you are helping us better tailor our birth support to all moms. We appreciate you taking time out of your day to do this! Please note that feedback provided here will be used for performance evaluations, and possibly as published feedback on the website.

* Indicates required field

Mom's Name *

First

Last

Partner's Name *

First

Last

Email *

Phone Number *

Baby's Name *

First

Last

Baby's Birth Date *

The Doula who attended my birth was: *

Sonja Kolstad Randi van Wiltenburg Kim Hayes Nikole Kehler

PLEASE RATE HOW YOU FELT BEFORE YOUR BIRTH, AFTER COMPLETING OUR PRENATAL MEETINGS

Were you... *

Your impending birth made you feel... *

Would you say you felt... *

Was the information we provided in our prenatal meetings helpful in handling the physical aspects of birth? *

Overall how would you evaluate the usefulness of having a Doula present at your birth? *

Was your Doula helpful in your first 30 days postpartum? *

Is there anything your Doula could have done differently, during your birth or postpartum period? *

If you were to have another baby, would you want a Doula to support you again? *

We occasionally update our resume references, for potential clients. Would you like to be included? *

How could we improve our overall services? Any additional comments? *

If you would like to leave a testimonial for our website, please write it here: *

Submit

BIRTH SUPPORT EVALUATION