POSTPARTUM DOULA/CHEF EXIT QUESTIONNAIRE


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 In an effort to continue to deepen the quality of my work and expand my offerings to further support families, I have created a brief "exit" questionnaire for the families I have supported as a postpartum doula and chef.  

I truly appreciate any feedback you can offer (all fields are optional).  Thank you in advance for taking the time to do this.  I of course know how demanding the first year postpartum is, so there is no rush or obligation to do this! If and when you have time, I welcome your responses.

Thank you for allowing me to be a part of this joyus moment of your lives!  Please stay in touch! 


 
 
Name *
Name
For example: the food, our conversations, herbal tea, having in-home support, etc.
I welcome constructive feedback on how I can continually refine my offerings and grow as a doula and chef!
Are there any resources you feel you need that we did not discuss in-person? Do you need any support groups or other professional referrals? (Ie. ongoing lactation support, babywearing, back-to-work support, support for postpartum depression or anxiety, processing or sharing your birth story, ongoing herbal support, etc.)
Would you be willing to write a testimonial about my work? If so, you can write it in the box below or send it to me via email at alicia@cloveraandtimothy.com at any time! I appreciate you taking the time to do this and fully understand if it's not something you are comfortable with or have time for at present.
for example/options: (full name, profession, first name with last initial) Jennifer Bridges, RN Jennifer Bridges Jennifer B.
Would you like to be added to my email list?
I send occasionally emails/newsletters to announce workshops, recipes, new offerings and products. You can always unsubscribe and I take no offense if you prefer not to be included.
Would you be willing to be a professional reference for me in the future? If so, please know that I always check in before providing your contact info to any prospective clients. In the event it is not a good time, you will have the opportunity to let me know.
Do you have any additional notes, questions or comments? If there is something you'd like me to offer as a service or workshop in the future, please let me know!
 

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