East Wing Visitor Feedback form

Thank you for taking the time to visit the East wing, Id be grateful for any feedback you care to give via this form ,which will help me to provide a better website as time goes by.(leave blank any sections you do not wish to fill in)Thanks Angie

Your name:............
Your email address:

Have you suffered a miscarriage? Yes No

If 'yes' how many? (if more then ten..how many?)

Did you find the medical profession in general to be
Very caring/helpful Indifferent Cold/rude
Well informed Ignorant regarding your feelings Other
If 'other' how would you describe your experience?

Please explain any good or bad experiences you had in so far as things people(medical or general public)did or said.

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I hope to develop this website more as much as i can what type of things would you like to see? (The most popular will be constructed first!)
Email pals page
My story page(for visitors to submit their miscarriage experience)
Abortion memorials
Pregnancy after loss info
Trying to conceive again info
If 'other' what are your ideas?

Regarding This website...

Have you found it to be If other please specify

Will you visit Eastwing again?

Will you tell others about this site?

Do you have a website?

If yes will you link to Eastwing?

****Thank you so much for your time!****

Bravenet kindly handles the CGI script for this form visit them here

NEW!!!! Find or Become an Pregnancy Loss Email support Pal!
(Talk with someone who understands!!!!)