How did you hear about me?
RecommendationTongue Tie websiteHealth professional

1. Were you seen in a timely manner?
YesNo
Additional Comments>

2. Did you see me for breastfeeding support or tongue tie division?
Breastfeeding supportTongue tie division

3. If you attended one of my clinics did it meet your expectations?
YesNo
Additional comments - please state which clinic you attended

4. Do you feel you were given adequate information to make a fully informed choice on treatment options?
YesNo
Additional Comments

5. Did you feel valued and respected?
YesNo
Additional Comments

6. Do you feel I cared for your baby in a professional manner?
YesNo
Additional Comments

7. Were you happy with the care you received?
YesNo
Additional Comments

8. Were you happy with the follow up contact?
YesNo
Additional Comments

9.Would you recommend me to others?
YesNo
Additional Comments

10. Please add any additional comments you would like to make