Survey for Moms

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Survey for Moms

We are grateful for your willingness to fill out this form.

Levata is an exciting new concept to Utah where moms would have a place to be supported at the most critical time after childbirth.

Think back to your postpartum time. Imagine there was care center for new moms and dads where you could stay for 5-30 days with your new baby.

How important would be the following services be to you on a scale of 1-10.

Spa Services:

not important

very important

Clear selection

Pelvic Floor Physical Services:

not important

very important

Clear selection

Lactation Consulting:

not important

very important

Clear selection

Meals Provided by a Dietician:

not important

very important

Clear selection

Newborn Photography:

not important

very important

Clear selection

Parent Education:

not important

very important

Clear selection

A Nursery to Care for the Baby:

not important

very important

Clear selection

Mother Wound Care:

not important

very important

Clear selection

Are there other services you would have wanted during your postpartum time?

Would you be more interested in an all inclusive experience or an a la carte stay?

All inclusive

Pay per service (health insurance coverage possibly)

Clear selection

If the above services were offered, how many days would you have wanted to stay at this care center?

Clear selection

If the above services were offered, how much would you spend per night to stay at this care center?

How would you finance your stay?

personally

shower fund

family (parent or in-laws)

I could not afford/not want to stay

Clear selection

How far would you be willing to drive to stay at this care center located in Utah County, Utah?

(No family members other than baby's mom and dad or adoptive parents would be invited to spend the night)

20 miles or less

50 miles or less

100 miles or less

200 miles or less

I would drive any distance for these services

Clear selection

If this care center was available at the time of your delivery, would you have been discharged from the hospital early?

yes

Clear selection

How old are you?

18-25

26-32

33-40

40-50

50+

Clear selection

What is your household annual income?

$0-$30,000

$31,00-$60,000

$61,000-$90,000

$91,000-$120,000

$120,000+

Prefer not to answer

Clear selection

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