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Rachel's Gift

Bereavement Care Survey

Did you receive a Rachel's Gift keepsake box? We'd like to hear from you! Your valuable input will help us improve our services to other moms and families enduring pregnancy and infant loss.

Did you receive a Rachel's Gift Keepsake Box in the hospital after your loss?
Yes
No
Was there a particular decision that you had to make that you wish you could have received more guidance and information on?
Yes
No
Do you feel you were given every opportunity to spend time with your baby while in the hospital?
Yes
No
Is there anything you wish you had done differently or made a different decision about?
Yes
No
Do you feel you were provided with enough options regarding end of life planning for your baby?
Yes
No
Do you feel you were treated with compassion and empathy by hospital staff?
Yes
No
Do you feel you were treated with compassion and empathy by your doctor or midwife?
Yes
No

If you wish to remain anonymous, your survey is complete.


If you don't mind sharing your name and email in case we have follow up questions to help us improve services or to address issues at a facility, please enter your contact information below. Ifwe contact a hospital about an issue we will never disclose wher the information came from unless you give express written consent for us to do so.

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