Moon Willow Doula, LLC
Elissa Lenkin Weber
CD(DONA), PCD(DONA), CLC
DONA-Certified Childbirth & Postpartum Doula
414 828-9203
willowdoula@gmail.com
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Postpartum Client Evaluation Form
Thank you for allowing me to be a part of your postpartum 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 postpartum doula?
Excellent
Good
Just ok
How would you rate your interactions with me prior to initiating support? (initial contact; intake, contract and payment; scheduling & communication; prenatal meetings if any etc)
Excellent
Good
Just ok
How would you rate the effectiveness of my support in addressing your physical, emotional and informational needs?
Very effective
Somewhat effective
Not effective at all
What do you feel was the most beneficial part of having a doula? How can I improve my doula services? Please provide additional feedback on any aspect of the services I provided to you.
Would you recommend my services to another mother?
Absolutely!
Maybe
No Way!
If you would like to provide a testimonial that may be used in promotional materials for Moon Willow Doula, LLC, please do so here:
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.
Moon Willow Doula, LLC and Elissa Lenkin Weber have my permission to use photos that I designate and provide via email in any advertising and promotional materials for Moon Willow Doula, LLC.
I DO NOT give permission for any photos to be used.
Send your feedback to Elissa
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