Share your Midwife Center experience

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Did you receive care at The Midwife Center, such as gynecological care, prenatal care, behavioral health counseling, lactation support, or other services? Did you have a great experience?

Have you supported TMC as a board member, staff member, volunteer, community partner, donor, or in another capacity?

We want to hear from you! We're collecting quotes, stories, and photos to share more about TMC with the wider community.

A few things:
- You don't need to answer all of the questions. Please just answer the ones that resonate with you and your experience at TMC.
- We will respect your privacy if you would not like your name to be used publicly. You'll have the option to give us another name to use. The information you provide below may be published in TMC print and online materials, and/or on our website. Language/quotes you provide may be used for public information and promotional purposes.

Feel free to contact Katie Phillips at k.phillips@midwifecenter.org for any additional information or questions.

Please let us know how you would like your name to appear online or in print/promotional materials. We can use your full name, only your first name, or another name if you prefer. Please type "no name" if you would rather we use your quotes/story completely anonymously. *

My pronouns are: *

She/Her

He/Him

They/Them

Other:

Required

Are you a Midwife Center client? *

Yes

Other:

I have used The Midwife Center for (check all that apply):

Gynecological or well-woman care.

Prenatal care and childbirth.

Behavioral health counseling

Wellness Walk-In Fridays

Lactation Support

Classes

Centering Pregnancy

Family Building Services (including IUI/ICI)

Other:

I have worked with The Midwife Center as (check all that apply):

Staff Member

Board Member

Advisory Committee Member

Volunteer

Community Partner

Donor

Other:

Please think about the care you've received at The Midwife Center. Did you have an appointment, an experience, or an interaction that lifted your spirits?

How was your healthcare experience at The Midwife Center different from healthcare experiences you've had elsewhere?

Did you receive care at The Midwife Center during a challenging time in your life? Can you tell us about it?

Why did you choose to receive care at The Midwife Center?

Why do you support The Midwife Center?

Is there anything else you would like to share about your experience with The Midwife Center?

Would you be willing to do any of the following? Please check all that apply and type your email address below.

Talk to the media about TMC.

Share my photos with TMC for use in promotional materials/website.

Volunteer at special events, outreach events, etc.

Share your experience in a Google Review.

Please enter your email address if you checked off anything above. Thanks! Your email address will be kept confidential.

Please read and sign: I give permission to The Midwife Center for Birth & Women's Health to use my/our written testimonial and to use photos of me/us and/or our family to be given to local media and used for promotional outlets of The Midwife Center, including print and email newsletters, website, other print and online materials, for the purposes of promoting The Midwife Center. (Please type your name below)

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