1. In what capacity did you interact with Maternity Services? *

 

2. Which department(s) or service(s) would you like to provide feedback on? *

 

3. When does your feedback relate to? *

 

4. What is your ethnicity

  • White
  • Asian or Asian British
  • Mixed
  • Black or Black British
  • Other Ethnic Group
 

5. Is English your first language?

 

6. What is your sex?

 

7. What is your sexual orientation?

 

8. How old are you?

 

9. What is your marital status?

 

10. What is your household income?

 

11. How did you hear about Jersey Maternity Voices?

 

12. Please tell us about your experience with maternity services in Jersey (this includes pre-conception, pregnancy, labour, birth, after-care, and the 4th trimester, including Health Visitors) *

 

13. What was good about your experience? (this may include positive feedback about specific midwives or consultants, comments about the facilities, additional support you may have had for example perinatal mental health support/breastfeeding support, how you were communicated with etc)

 

14. What was not so good about your experience?

 

15. What could have been done differently to improve your experience? What changes would you like to see?