POSTPARTUM CARE *

Please rate the following aspects of your postpartum care.

The number of postpartum visits met my needs

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

The scheduling of postpartum visits met my needs

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

It was easy to reach the Program in the postpartum period

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I was provided with useful information about caring for myself

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I was provided with useful information about caring for my baby

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I felt supported to breastfeed and/or choose how I fed my baby

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I felt comfortable contacting a member of the Program with questions or problems

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

COLLABORATIVE CARE *

Please rate your experience of our collaborative model below.

There were adequate opportunities to meet and get to know the team members involved in my care

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I understood how to reach the Program with questions or scheduling changes

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

(If seen by a Registered Nurse at home) I was satisfied with the care you received from the nurse

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

It was clear prior to my postpartum visit, who was seeing me that day (Midwife, Physician or Nurse)

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

The collaborative team communicated well and my care was well co-ordinated.

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Name

First Name

Last Name