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. What is your gender?


6. How old are you?


7. What is your marital status?


8. What is your household income?


9. Is English your first language?


10. Please tell us about your experience with maternity services in Jersey. *


11. What was good about your experience?


12. What could have been done differently to improve your experience?