JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Customer Feedback
We would love to hear your thoughts or feedback on how we can improve your experience!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Have you attended any antenatal class? how many ?
0
1
2
3
4
5 and above
Clear selection
How many did you attend with your partner?
*
0
1
2
3
4
5 above
Other:
Where did you have your antennal classes?
Same hospital as delivery hospital
Different hospital from delivery hospital
Community Health Center
Other:
Clear selection
What didn't you like about your antenatal classes?
Your answer
What would you have loved to see/experience at your antenatal class.
Your answer
Would you pay for an antenatal class
Yes
No
Maybe
Clear selection
For No? Why didn't you attend any antenatal Class?
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
