Client Feedback & Satisfaction Survey
Thank you taking the time to let us know how we did. We hope we were able to make you happy. Please answers these questions to help us in our goal to consistently improve the services we offer. And remember: Once you're a Metro Mommy Agency client, you're always in the #metromommy family. Please stay in touch and let us know how we can continue to support you.
Name
*
First Name
Last Name
Your baby’s birthday (we would love to send a gift!)
-
Month
-
Day
Year
Date
Your birthday (we want to celebrate you, too!)
-
Month
-
Day
Year
Date
Email
*
example@example.com
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What is the name of your Doula?
*
How would you summarize your Doula Support experience?
*
What was your doula's strengths?
*
Would you hire your doula again in the future?
*
Yes, of course
No, thank you
Maybe
There is room for improvement for my doula in the following areas:
*
What services did Metro Mommy Agency provide?
*
Birth Doula Support
Postpartum Doula Support
Lactation Support Group
Breastfeeding Consultation (In-person/At Home)
Childbirth Education (CBE) (Virtual Prenatal Education or Crash Course)
HypnoBirthing Childbirth Education (5-week series)
Nutrition Coaching & Meal Planning
Speaking Engagement
Consulting Services
Other
If you completed a HypnoBirthing Course with Metro Mommy Agency, did you use the techniques in labor?
YES
NO
Sometimes
I feel I received the quality of services I expected from Metro Mommy Agency
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
I would recommend Metro Mommy Agency services to other families
*
Strongly Disagree
1
2
3
4
Strongly Agree
5
1 is Strongly Disagree, 5 is Strongly Agree
My family/friends in attendance during/after my birth were satisfied with the support I received from Metro Mommy Agency
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Before receiving services, my confidence level for managing pregnancy, birth or postpartum
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
AFTER receiving services, my confidence level for managing pregnancy, birth or postpartum
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
What were best parts of your experience?
*
What are some ways that your think Metro Mommy Agency can improve/make services better?
*
Any other thoughts, questions or concerns?
*
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May we share your feedback and photos sometime? NOTE: This permission is optional. Statements and photos may be used in our materials, print, or video. We value your feedback and your privacy.
*
Yes, my comments and photos may be shared.
Yes, my comment and only select photos I approve may be shared. Please call me to discuss.
No, thank you, my comments are for internal use only and may only be shared with Metro Mommy Agency.
Would you be willing to leave a review on our Facebook, IG, Google, and Yelp pages? (We will follow up with an email with links to do this easily.)
Yes
No
Maybe
Can we share your experience on our website?
Please Select
Yes
No
If we can share your experience, please select how you would prefer it to be shared.
Please Select
Share Full Name
Share Initials
Share Anonymously
Signature:
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