MVP - Meetings Monitoring Form

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* 1. What type of maternity service user are you?

New

Existing

None of the above

Other (please specify)

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* 2. Was your meeting conducted?

Face to Face

None Face to Face

Other (please specify)

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* 3. Which category best describes your profession?

Maternity Staff

Other NHS Staff

Public Health

Social Care

Third Sector

CCG

None of the above

Other (please specify)

Question Title

* 4. Which category best describes you as a service user if applicable?

Expectant Mother

Mother

Partners

Children

Grandparents

Siblings (of parents)

Non-Family

Doulas

None of the above

Other (please specify)

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* 5. Your age?

<18

18-20

21-30

31-40

40+

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* 6. Gender

Male

Female

Other (please specify)

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* 7. First language spoken?

English

Non-English

Other (please specify)

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* 8. What is your Ethnicity?

White British

White other

White/Black Caribbean

White/Asian

Other Mixed Indian

Pakistani

Bangladeshi

Arab

African

Black Carribean

Other (please specify)

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* 9. Would you consider yourself to fall into any of the following groups?

BAME

Asylum Seekers

Refugees

Gypsy or Traveller Community

Teenage Parents

Homeless

LGBT

People with learning difficulties

None of the above

Other (please specify)

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* 10. Dependants?

First Child

Subsequent Child

No Children/Non Parent

Other (please specify)

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* 11. Where did our meeting take place?

Trust Site

Children's Centre

Coffee Shop

Virtual Meeting

Other (please specify)

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* 12. Mothers area of residence?

Rochdale

Oldham

Other (please specify)

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* 13. Place gave birth?

Royal Oldham Labour Ward

North Manchester Labour Ward

Royal Oldham Birthing Suite

North Manchester Birthing Suite

Home Birth Oldham

Home Birth Rochdale

St Mary's Manchester

Bolton Hospital

Outside of hospital (enroute, unexpectedly at home, in triage)

Not yet given birth

Other (please specify)

Question Title

* 14. Antenatal Care Provider?

Rochdale

Oldham

None of the above

Other (please specify)

Question Title

* 15. Postnatal Care provider?

Rochdale

Oldham

None of the above

Other (please specify)

MVP - Meetings Monitoring Form

Question Title

* 1. What type of maternity service user are you?

Question Title

* 2. Was your meeting conducted?

Question Title

* 3. Which category best describes your profession?

Question Title

* 4. Which category best describes you as a service user if applicable?

Question Title

* 5. Your age?

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* 6. Gender

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* 7. First language spoken?

Question Title

* 8. What is your Ethnicity?

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* 9. Would you consider yourself to fall into any of the following groups?

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* 10. Dependants?

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* 11. Where did our meeting take place?

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* 12. Mothers area of residence?

Question Title

* 13. Place gave birth?

Question Title

* 14. Antenatal Care Provider?

Question Title

* 15. Postnatal Care provider?

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* 16. Please enter your email to sign up to the mailing list