POSTPARTUM EVALUATION FORM
QMA Risk Management LLC
Victoria Grace 1/24/2012
"Feedback is the breakfast of champions!" �Ken
Contains a combination of open-ended questions,
multiple-choice questions and a rating system. Be specific and
restrict your questions to the most value added.
Include the following areas:
- medical care
- client�s experience
- request for additional input � be specific
Add other areas you are concerned with or want feedback on.
Don�t wait until postpartum to ask for feedback � can ask �how am I
doing?� verbally at any time � take notes.
the evaluation and explaining the purpose at the home visit and
asking for its return at the postpartum visit. Be inventive
with ideas to make getting them back easier and more rewarding for
your clients and yourself.
Evaluate usefulness: modify
the evaluation form to meet your current needs for feedback
Review the feedback obtained and make changes to your practice