Postpartum Health Program Survey
Help us improve our postpartum health program by sharing your experiences and feedback. Your responses are confidential and valued.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
How many weeks postpartum are you?
*
How would you rate your overall postpartum health?
*
1
2
3
4
5
Which of the following challenges have you experienced postpartum? (Select all that apply)
*
Fatigue
Mood changes
Breastfeeding difficulties
Physical pain or discomfort
Sleep problems
None of the above
Other
Please rate your satisfaction with the following aspects of the postpartum health program:
*
Rows
Very dissatisfied
Dissatisfied
Neutral
Satisfied
Very satisfied
Program content
1
2
3
4
5
Support from staff
6
7
8
9
10
Accessibility of resources
11
12
13
14
15
Group sessions
16
17
18
19
20
Follow-up care
21
22
23
24
25
Which resources or services did you find most helpful?
Educational materials
Support groups
One-on-one counseling
Online resources
Home visits
Other
Did you feel adequately supported emotionally during the program?
*
Yes
Somewhat
No
What improvements would you suggest for the postpartum health program?
Would you recommend this program to other new mothers?
*
Yes
Maybe
No
Is there anything else you would like to share about your postpartum experience or the program?
Submit Survey
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