Help Share

1. What is your name?

2. How can we contact you (phone number, email address, etc.)?

3. When was your loss? Length of pregnancy? What type of loss did you have?

4. Where did you deliver / have surgery / end your pregnancy (if not at a hospital or doctors office)?

5. What type of support did you receive from there? Was it helpful? Please be as detailed as you are comfortable sharing.

6. What would you have preferred (my answer of "Not Losing Matthew" can not be used :) )for support?

7. Did you receive any follow up phone calls or visits? How many / how often?

8. What tangible items did you receive (footprints, hospital bands, umbilical cord clamp, lock of hair, blanket, measuring tape to name a few)? Knowing what you know now, what do you wish you had then? My wish is that we had more than one picture of Matthew.

9. Did you go in for your 6 week check up? Why or why not (again, only if you are comfortable sharing...the people that are forming this group mentioned that not many women go back for their follow up visits - mainly due to insurance issues.)

10. Do you feel like you are in a place in your own grief journey that you can reach out to others during their hour of need?

11. What are your strengths (some people are amazing on the phone, I am not.)?

12. Where do you feel you might be able to help another family (in the hospital, in your home, in their home, in a public place or at a Share meeting for example)?

13. When would you be willing to help (get a call from the nurses as soon as the families say it's ok to call, visit them at home a few days later, call them as often as they feel or want to be called or other situations)?