MAPS' NICU Program
Thank you for taking the time to provide us with your input and feedback regarding our new NICU Parents' Program!

We are still in the very early stages of this program, but we are excited about the possibilities and cannot wait to bring it to our local hospitals.
Sign in to Google to save your progress. Learn more
Email *
Name
Email (in case we have follow-up questions)
About the NICU Program
MAPS is partnering with Wisconsin NICU Parents to create a volunteer, peer-support program that will match current NICU parents with local parents who have graduated from the NICU (about a year+ out from the experience). The goal is to provide emotional and mental support to the new parent(s).

We are introducing our program at the Meriter NICU first. The nurses will provide information upon admission to the NICU so parents are able to contact someone from our program right away if they're interested. We'll also have a form they can fill out at discharge giving our volunteers permission to contact them after they are discharged.

The program will consist of a check-in while the family is still at the hospital (if requested), another around 2-3 weeks after baby's birth, then again at 8-12 weeks, plus a few more up until baby's first birthday. However, our volunteers will also make themselves available outside of those scheduled check-ins based on each family's needs.
After reading the above ^ What are your initial thoughts on the program?
Would you have taken advantage of a service like this immediately after your baby was born?
Clear selection
Would you have taken advantage of a service like this a few weeks / months after baby was born?
Clear selection
What support did you receive at hospital and in the months following your discharge from the NICU that you really appreciated?
What support did you WISH you had received at the hospital and in the months following your discharge?
After reading about the program, is there anything you would change?
Would you and/or your partner be interested in participating in this program as a volunteer?
Clear selection
Any additional thoughts / comments / suggestions / concerns:
Thank You!
This program wouldn't be a success without input from parents like you. Thank you for taking the time to fill out this form.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy