Natal Hypnotherapy Feedback Form

Your name and date of birth
Baby's date and place of birth
How many children do you have?
Which products did you use?

























Did you use any of these for the birth:

























What impact did the CDs have on your experience:- 1 = Did not help at all 2 = Occasionally helpful 3 = Helpful some of the time 4 = Helped a lot 5 = helped most of the time 6 = were extremely helpful
Feeling relaxed before the birth
Overcoming fear
Increased trust and belief in my body
Feeling calm during the birth
Ability to manage the pain
Feeling of being in control
Did you benefit from Natal Hypnotherapy?



How much impact did it have?
Would you recommend Natal Hypnotherapy?



Would you be happy...





Any suggestions for improvement
Your pregnancy and birth story
Tel / E-mail (for our use ONLY)
Your location