top of page
Client Evaluation Form
 
Thank you for allowing me to be a part of your birth experience. I sincerely hope that my services were beneficial for you and your family.  If you were dissatisfied with my services for any reason and would like to talk about it, please do not hesitate to contact me by phone or email. Thank you for taking the time to complete this evaluation. Your feedback will help me continue to improve the service I offer to families. 
How would you rate your overall experience having me as your doula?
How would you rate your interactions with me prenatally? (initial contact, follow-up communications, scheduling, meetings and phone consults etc.)
How would you rate my effectiveness at meeting your physical, emotional and informational needs during labor and delivery?
How would you rate my effectiveness at meeting your needs postpartum?
How would you rate my effectiveness at meeting your partner’s needs throughout this journey together?
Would you recommend my services to another mother?
A picture is worth a thousand words, so I am grateful to clients who allow me to use photos of themselves and their babies in my advertising and promotional materials. If you have photos that may be used by Moon Willow Doula, LLC for this purpose, please choose the appropriate box and forward them to me at willowdoula@gmail.com. Thank you for your support.

Thank you for submitting your feedback!

bottom of page