Birth client response form Birth Client Response Form For clients to complete when they have been supported for a birth by a Mentored Doula. Your Initials * Name of your Mentored Doula * Email address of your doula's Mentor (please ask your doula if you don't know their Mentor's email address). Please note, this form will be sent directly to the Mentor and stored securely * How did you first hear about doulas? * Why did you decide to have a doula? What was your expectation of the support they would provide? * How did you find your doula? * Doula UK Find a Doula search Doula's website Doula's social media Word of mouth/recommendation OtherOther Did you interview more than one doula? * Yes No Why did you choose this particular doula? How do you feel about the quality of information and support given by your Doula in the antenatal period? * Excellent Good Satisfactory Poor Very poor Please explain your answer in more detail How do you feel about the quality of your doula's support during labour and birth? * Excellent Good Satisfactory Poor Very poor Please explain your answer in more detail How do you feel about the quality of your doula's support immediately after the birth? * Excellent Good Satisfactory Poor Very poor Please explain your answer in more detail How do you feel about the quality of your doula's support in the first few weeks after the birth? * Excellent Good Satisfactory Poor Very poor Please explain your answer in more detail Would you have a doula if you had another baby? * Yes No Please explain your answer in more detail (optional) What would you say to other parents considering having a doula? Please give specific feedback about your mentored doula? Consider your doulas personality, knowledge, empathy and ability to support you in your wishes * Do you feel your doula was mindful of (and sensitive to) your circumstances, abilities, background, race, religion, gender identity or orientation? * Yes No Please explain your answer in more detail (optional) If applicable, are there any comments your partner would like to add? Fee paid to the mentored doula * Would you like to discuss any concerns with your doula's Mentor? If so, please enter your email address or telephone number here Your doula may wish to use your words on this form to show potential clients, or as a testimonial on their website or social media. Please could you indicate whether you agree to this? * Yes, with my initials Yes, without my initials No, please do not share any of the words The doulas potential clients may also appreciate contacting you for a reference. If you are happy for them to do this, please add your email address or telephone number here Submit