Maternity Testimony Survey

Please fill out each question to the best of your abilities. Type N/A in any comment boxes that don't apply to your story.

Please note: By filling out this survey, you are giving your consent to Christian Healthcare Ministries (CHM) to use the information you provide (including your name, your image, and/or any interview statements) now or in the future in CHM’s publications, social media, print media, electronic media, advertising, or other media or promotional activities. This consent is given in perpetuity, and does not require prior approval from you.

1.What is your name and member number?(Required.)

2.Why did you join CHM?(Required.)

3.What were your initial thoughts when you found out you were pregnant?
What were you looking forward to the most?(Required.)

4.Were there any complicating factors in your pregnancy or pregnancies?
When did you realize you needed additional medical attention?
Share a little of the story behind them and whether CHM was helpful to you.(Required.)

5.What thoughts or emotions were playing through your head during this time?(Required.)

6.What did God teach you during this pregnancy?(Required.)

7.Did you interact with any CHM staff?(Required.)

Yes (If yes, explain that experience)

8.Select any of the below information that applies to you, your membership, or your incident:

Self-employed

Brother's Keeper

Prayer Page

Groups member

Other (please specify)

9.Would you recommend the CHM Maternity program to other young couples desiring to have children?
Why or why not?(Required.)

10.Have you received cards, letters, or prayers of encouragement from fellow CHM members or staff?
Were there any moments where you felt ministered to?(Required.)

11.Every story is unique. Is there anything else to your story that you’d like to share?(Required.)