The results of this form are confidentially acquired and stored via google in our private googledrive. If you prefer to fill the form out online, do so at: https://docs.google.com/forms/d/1kOZKGcl4702DMa0zE6lYc_TZFnnPs8wcZ69u6iMzQjs/viewform#start=invite
PART 1: CONFIDENTIAL BIRTH REPORT (required)Please provide information regarding your birth. This information is required by American Academy of Husband-Coached Childbirth (AAHCC) to update their statistics. Click the check box for any detail you prefer to keep blank if you do not want to submit all of the information.
PART 2: RATING OF YOUR PREGNANCY/BIRTH TEAM (optional)This information will help us recommend providers to our students, by giving us a clearer picture of what they offer, what they support, what they don't support, their bedside manner, etc, which is helpful when a student is in need of a new provider or other pregnancy/birth related service. This information is only used to help other students and your name is not provided. This is not passed on to AAHCC; only used by us to help our students.
PART 3: SHARE YOUR BIRTH STORY WITH US! (optional)If you have not already done so, you may tell us your birth story and/or comments how our classes helped you with your birth for inclusion on our webpage(s) or for us to learn from. (This will not be submitted directly to AAHCC unless you click permission for us submit it for consideration to post on their birth story page at http://bradleybirth.com.) You may want to write this separately and then copy and paste into the form, or email it to us if desired.
PART 4 (required): Please give or deny permission to share your birth story or opinions of your providers. We will not disclose your name to anyone but simply pass along your experience or comments.
PART 5 Tell us if you would like information about any upcoming reunions we may plan for our students and/or if you would like to come to a current or upcoming series to share your birth story.
We would also like to know if you are interested in becoming a Bradley instructor/doula.
Thanks in advance for helping us update our records!
1. Name & area(s) of expertise2. Location of practice/office or community serving3. Your opinion of the services provided or any other info you think would be of interest to prospective clients from our classes.
Or if you prefer, you can skip the individual questions and rate your providers with a scale though this is not as helpful for providing recommendations.
Click the button to submit. You may edit your answers if something needs changing.
Thank-you very much for your particiipation in the Bradley Birth Survey and our optional birth story and comments section.
Nancy & George