Cleaning in Action Program Family Feedback Survey
Thank you for participating in the Cleaning in Action Program! We are so grateful to have supported your family during this time. Your feedback helps us improve, reach more NICU families in need, and secure grants to continue providing this service. Please take a few minutes to share your honest thoughts and experiences — your voice truly makes a difference.
Name
First Name
Last Name
Email
example@example.com
How did you first hear about the Cleaning in Action Program
Hospital Staff
Social Media
Another NICU Family
I See You NICU Representative
Other
Approximately how many hours of cleaning were provided?
1-2 hours
3-4 hours
5+ hours
Not sure
Before receiving the cleaning service, how would you describe the condition of your home?
Very difficult to manage
Somewhat difficult to manage
Manageable
Easy to maintain
How much stress were you experiencing related to home upkeep before the service?
Extremely high
High
Moderate
Low
How did the cleaning service impact your overall stress level?
Greatly reduced
Somewhat reduced
No change
Did having your home cleaned help you focus more on your baby and family needs?
Yes, very much
Somewhat
Not really
Not at all
In what ways did the Cleaning in Action Program make a difference in your life?
How did it make you feel when you came home after the cleaning?
How would you rate your satisfaction with the cleaning service overall?
1
2
3
4
5
Would you recommend the Cleaning in Action Program to other NICU families?
Definitely
Probably
Not Sure
Probably Not
Are you interested in having routine cleaning?
Yes
No
If this service had not been available, what would your home situation have been like?
What other types of support would have been helpful for your family during or after your NICU experience?
After receiving the cleaning, did you notice any improvement in: (Check all that apply)
Mental health and emotional wellbeing
Family time or bonding
Physical health or cleanliness of home
Ability to focus on your baby's care
Motivation to keep your home up
On a scale of 1-10, how valuable was this service to your family's recovery and transition home? 1 = Not valuable / 10 = Extremely valuable
Would you be willing to share your story or testimonial to help other families receive this support?
Yes, publicly
Yes, anonymously
No
How important do you think programs like Cleaning in Action are for NICU families in need?
Essential
Very important
Somewhat important
Not important
Any final thoughts, suggestions, or words you'd like to share with I See You NICU or future families?
Submit
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