Maternal Resource Guide feedback form
It is Utah Women and Newborn's Quality Collaborative's goal to keep the Maternal Resource Guide up-to-date, relevant to Utah moms, and with the best information possible. This form is a way to let us know of new resources, what is working well about the guide, changes in information, and things you would like to see in the guide. Please fill out the form below to inform us of anything that could be improved in the guide. All feedback form fields are optional. Thank you!


Sign in to Google to save your progress. Learn more
Name
Email –In case we need to follow up or thank you for your comment.
What suggestions do you have to improve or update the Maternal Resource Guide? 

Are there any free or low cost resource(s) could we add that benefits moms and families in Utah?

Is there a particular resource that has out of date information? If so, what changed?
**This guide was created to remove barriers for Utah families, especially those who are most vulnerable. We focused on including resources and services that are relevant to this goal. If a resource or service does not align with this goal, it might not be included in the guide.

If you would like to submit your resource to be added to the guide, please include information that verifies that it meets our current criteria for additions to the resource guide: 

- Does not require social security or citizenship documentation to receive care or resources

- Free or low-cost, and/or accepts Medicaid

- Translation services available in Spanish, Spanish-speaking staff, or another language aside from English
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of State of Utah. Report Abuse