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How did we do?

1. Was your visit at HerChoice helpful and informative?

2. If answered yes to question 1, what was the most helpful and/or informative part of your visit?

3. How can we improve our services?

Please enter an 'other' value for this selection.

4. Were you comfortable and did you feel heard?

Yes	Somewhat	No
Yes	Somewhat	No

5. Will you allow for us to contact you?

6. If you answered "no" to question 5, why? Click all that apply. *This question is required.

I feel uncomfortable.
I don't feel like I need to talk to anyone.
I'd rather not let you know what my choice is for this pregnancy.
Other - Write In (Required) Please enter an 'other' value for this selection. * This question is required.

7. Would you recommend HerChoice to a friend?

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