Evaluation of Services

Evaluation of Services
Congratulations on the birth of your baby! Birthing In Korea is very honoured to be a part of such an intimate moment in your life. As part of our ongoing evaluation of our services, we would like you to complete the following evaluation of the services that you were provided. Once the form is completed, click the "Submit" button. Thank you for taking the time to give us your feedback!
Doula's Name:

First NameLast Name
Mother's Name:

First NameLast Name
Father's Name:

First NameLast Name
Baby's Name:

First NameLast Name
Delivery Date:

MonthDayYear
Services Survey
Would you recommend us to friends, family or co-workers?
Would you use our services again?
Would you be willing to be a reference for future clients?
Prenatal Support
How did you feel about the amount of time that was spent with you during the prenatal period?
Please list the top 3 things you found extremely helpful during your prenatal time:
Is there anything during the prenatal time that we can do differently to improve our services?
Labour and Delivery Assistance
How did you feel about the amount of time that was spent with you during the labour and delivery period?
Please list the top 3 things you found extremely helpful during your labour and delivery time:
Is there anything during the labour and delivery time that we can do differently to improve our services?
Postpartum Support
How did you feel about the amount of time that was spent with you during the postnatal period?
Please list the top 3 things you found extremely helpful during your postpartum time:
Is there anything during the postpartum time that we can do differently to improve our services?
Summary
How would you describe your overall phone support time?
What do you feel was the most beneficial part of having a doula?
Your Testimonial or Birth Story (Optional)
Thank you for being willing to write a short testimonial for Birthing In Korea! We really appreciate all of the things you have to say.

Here are some tips for writing your testimonial:

1. Please use your first names only.

2. Include how you heard about Birthing In Korea.

3. Talk about any classes you attended.

4. Talk about your Doula and the services she provided.

5. Include anything you think applies to your experience with Birthing In Korea

6. Remember, it doesn't have to be long!
If you choose, please write your testimonial or birth story here:
Upload your complete testimonial or birth story here:

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Permissions
All permissions given to Birthing In Korea have the assumption that only first names will be used in the publishing of your family information. No last names or contact information will be given out without your express permission. In regards to photos, only photos of appropriate content will be used. No photos of any delivery or of an intimate nature will ever be used.
Do you give Birthing In Korea permission to publish your birth story?
Do you give Birthing In Korea permission to keep a copy of your birth announcement?
Do you give Birthing In Korea permission to use photos containing your image, your baby's image, or your family member's image?
Do you wish to remain anonymous?
Do you wish to be added to the Birthing In Korea mailing list to receive parenting updates and invites to future events?
Should be Empty:

Evaluation of Services

Services Survey

Prenatal Support

Labour and Delivery Assistance

Postpartum Support

Summary

Your Testimonial or Birth Story (Optional)

Permissions