Congratulations on the birth of your baby! We hope that you and your family are doing well – do not hesitate to call us if we can help with any concerns you may have. It is always our goal to provide an optimal experience for our patients throughout their pregnancy, delivery, and recovery period. We would appreciate it if you could take a moment to answer a few questions that will assist us in evaluating our delivery of service to you and your family.
PRENATAL PERIOD
1) While receiving your prenatal care, did you have any problems scheduling your appointments?*
2) Were you seen in a timely manner when you came in for appointments.
3) Were the doctor’s assistants that prepared you for your visit friendly and helpful?*
4) Were you happy with the care that was provided by your doctor/midwife during your visits?
5) If you could change anything about your prenatal care, what would that be?
LABOR AND DELIVERY


* Please rate the following from 1-10 with 1 being poor and 10 being excellent.


1) Doctor/Midwife spent enough time with me during my labor?
1 2 3 4 5 6 7 8 9 10
2) Doctor/Midwife met all my needs during this time?
1 2 3 4 5 6 7 8 9 10
3) Doctor/Midwife made my labor and delivery special?
1 2 3 4 5 6 7 8 9 10
4) Doctor/Midwife met all my expectations during my delivery?
1 2 3 4 5 6 7 8 9 10
If you could change anything about your labor and delivery, what would that be?
I delivered on ( Date and Time )Example: 05/17/2000 5:00PM
Did any one person impact your experience in either a positive or negative manner while receiving care through WWC.
Please feel free to comment about any aspect of your experience with our practice. We truly appreciate your feedback and will utilize this information to improve our care when indicated. If you would like to talk to our office manager, Linda Heller, she can be reached at 303-424-6466. Thank you for allowing us to share in this important time of your life!


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