COMMUNITY MIDWIVES OF BRANTFORD
  • Intake Form
  • About Us
    • Our Midwives
    • Birth Stories
    • Location
    • Contact
    • Student Evaluation
  • What is Midwifery?
  • Pregnancy
    • Pregnancy Care for Clients
    • When to Call your Midwife
    • Working with Students
    • Pregnancy Resources
    • Booklist
    • Crisis Lines
  • Birth
    • Home and Hospital Birth
    • Midwifery Care During Birth
    • Preparing for Birth
  • Postpartum
    • Care for Clients After Birth
    • Care for the Newborn
    • When to Call Your Midwife
    • Breastfeeding
    • Leaving Midwifery Care
    • Midwifery Care Evaluation Form

CLIENT EVALUATION OF MIDWIFERY CARE

    Please take some time to provide us with your evaluation of the
    midwifery care that you received during your recent pregnancy, birth and
    postpartum period.
    Please complete the form below. 
    ​
    Basic Information






    Prenatal Care​
    Please rate the following aspects of your prenatal care.






    Labour and Birth Care
    Please rate the following aspects of your labour and birth care.









    Post-Birth Care
    Please rate the following aspects of your post-birth care.











    Continuity of Care
    ​Midwives are required to provide “ Continuity of Care” to their clients. This is defined as 24-hour on-call
    availability of one of the group of midwives known to the client throughout the course of care. Please
    comment on your experience of the arrangements made by the practice group to provide this care.




    Scope of Practice
    ​The midwifery scope of practice includes the provisions of care during normal pregnancy and normal
    vaginal delivery. In some cases complications arise during pregnancy, birth or in the postpartum period
    which require consultation with, and sometimes transfer of care to, another health care provider (i.e.
    obstetrician, pediatrician). Please comment on the following aspects of your care regarding this issue.




    Philosophy of Midwifery Care in Ontario
    ​The “Philosophy of Midwifery Care in Ontario” recognizes the childbearing woman as the primary
    decision-maker in her own care. Please comment on your experience of receiving information and
    making decisions while in midwifery care.




    Student Involvement
    If a student was involved with your care, please answer the following.




    Office: Staff and Location
    Please rate your experience with our office staff and location.
    ​How were you treated by our office staff when you:

    ​How would you rate the characteristics of the office staff:

    How would you rate the Practice Office:


    Optional Information
    We keep all feedback confidential, but if you wish to remain anonymous, please feel free to leave the following questions blank.

    Thank You
    The Community Midwives of Brantford

Submit
Community Midwives of Brantford

​217 Terrace Hill Street, Suite 100,
​Brantford, ON
N3R 1G8
Email: CMOBon98@gmail.com
Telephone: (519) 751-6444
Pager: 
1-888-257-4070
Fax: (519) 751-9196



​
  • Intake Form
  • About Us
    • Our Midwives
    • Birth Stories
    • Location
    • Contact
    • Student Evaluation
  • What is Midwifery?
  • Pregnancy
    • Pregnancy Care for Clients
    • When to Call your Midwife
    • Working with Students
    • Pregnancy Resources
    • Booklist
    • Crisis Lines
  • Birth
    • Home and Hospital Birth
    • Midwifery Care During Birth
    • Preparing for Birth
  • Postpartum
    • Care for Clients After Birth
    • Care for the Newborn
    • When to Call Your Midwife
    • Breastfeeding
    • Leaving Midwifery Care
    • Midwifery Care Evaluation Form