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* 1. Name

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* 2. What is your date of birth?

Date

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* 3. Martial Status

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* 4. How many weeks pregnant are you?

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* 5. When are you due your baby?

Date

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* 6. How many children do you have?

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* 7. Highest level of Education

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* 8. Ethnic Background

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* 9. Have you attended an antenatal course?

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* 10. If you have not attended any prenatal information classes please tell us why.

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* 11. Who ran the antenatal course you attended?

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* 12. What type of course did you attend?

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* 13. What information did you receive at the antenatal class you attended?

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* 14. What was your experience of the antenatal class you attended?

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* 15. What was your overall satisfaction levels with the antenatal class you attended?

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* 16. Was there any extra information you wold have liked the class to cover?

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* 17. How were you made aware of this class?

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* 18. Can we contact you again should we have further questions about your antenatal experience?

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* 19. If yes, please leave your name and contact details...

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