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* 1. Where did you deliver?

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* 2. On a scale of 1 to 10, how would you rate your prenatal care. 1 being best, 10 being worse.

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1

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* 3. How was your overall experience with the staff? 1 being best, 10 being worst.

  1 2 3 4 5 6 7 8 9 10
Row 1

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* 4. How would you rate your birth experience? 1 being best, 10 being worst.

  1 2 3 4 5 6 7 8 9 10
Row 1

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* 5. How would you rate the cleanliness of the center? 1 being best, 10 being worst.

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1

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* 6. How was the overall experience of your prenatal care, labor, delivery, birth and postpartum care? 1 being best, 10 being worst.

  1 2 3 4 5 6 7 8 9 10
1

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* 7. Do you feel like you and your partner recieved enough information during your care?

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* 8. How can we improve our services and care?

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* 9. From start to finish, what was your favorite thing and least favorite thing?

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* 10. Would you come back again or recommend to your friends and family?

T