Beyond Birthing Doula Services Review and Outcome Form
Please share your feedback and experiences with our doula services. Your input helps us improve and support future families.
First Name Last Initial
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First Name
Last Name
Email Address
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example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Approximate Date(s) of Doula Support
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Did you have a doula before or know what a doula was?
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No, first pregnancy
First pregnancy, but I know/knew what a doula was
No doula before and doula what?
Yes, I know what a doula is because I had a doula before, but not Morgan
How many births has Morgan support you throughout?
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What is/was your birthing location?
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Hospital, Birth Center, Home. If you are outside of Delaware, please also state the state in which you delivered. Also note if birthing location changed due to labor (e.g. transfer from birth center to hospital)
Birth Outcomes— However you did it… You DID THAT!!
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How did you hear about our doula services?
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Please Select
Friend or family referral
Healthcare provider
Social media
Online search
Community event or class
Divine Appointment in a Random Place
Did you use placenta services?
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Yes
No
Not by Beyond Birthing
How satisfied were you with your overall doula experience?
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1
2
3
4
5
How prepared did you feel for your birth experience after working with Morgan?
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Not prepared
1
2
3
4
Very prepared
5
1 is Not prepared, 5 is Very prepared
What were your expectations about doula support? Specific expectations of Morgan?
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If you had a doula previously, what were some differences that changed your experience with Morgan’s support?
How satisfied was your partner with the doula support provided?
Not satisfied
1
2
3
4
Very satisfied
5
1 is Not satisfied, 5 is Very satisfied
How did the doula support you received compare to your expectations?
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How prepared did your partner feel for the experience?
Not prepared
1
2
3
4
Very prepared
5
1 is Not prepared, 5 is Very prepared
What was your favorite part of your doula experience?
Would you refer our doula services to others?
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Yes
No
Maybe
Any additional comments or suggestions?
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