Geelong & Surfcoast Doula Services - Supporting Geelong families since 2010
Online Feedback Form
This form is designed to be used by clients who have previously contracted the services of Geelong & Surfcoast Doula Services. 
We appreciate you taking the time to provide us with this valuable feedback. 




Client Feedback Form
Service Provided
Your Name
Your email address
Doula's name
How did your Doula relate to you ?
Very well
Quite well
Reasonably well
Could have been improved
Not at all
Did your doula provide you with detailed and relevant information?
Valuable Information
Adequate Information
Some information
Little or no information
Did your doula provide you with emotional support
Excellent support
Good Support
Reasonable Support
Some support
Insufficient or little support
Did your doula provide your partner with emotional support ?
Excellent Support
Good Support
Some Support
Adequate Support
No Support
Not applicable
Was there anything more your doula could have done to assist you ?
Was there anything your doula said or did that you believe had a negative impact on your experience ?
Would you write a brief testimonial for your doula to use for future clients or marketing purposes ?