Mother and Pepi Evaluation Survey

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Thank you for agreeing to participate in this evaluation of the Mother and Pepi Services. The purpose of this survey is to understand what you and your whānau think the Mother and Pepi, how we are doing in supporting you and how we can improve.

You can fill out the survey individually or in a group/whānau setting. If you have any questions or need help completing some of the sections,, please talk to your Mother and Pepi whānau worker.

Please complete this form and once completed, submit via the button at the bottom of the survey.

General Information

To start off, we would like general information about you and the Mother and Pepi services you and your whānau have used, so we can help further develop services to your needs.

  • Service from Whānau worker

    Thinking about your Whānau worker and the service in general, to what extent do you agree or disagree with the following statements?

  • Changes for you and your baby as a result of the support you received:

    Please indicate to what extent you agree that in the following areas you have experienced significant improvement by your involvement with the service:

  • Overall, how satisfied are you with the Mother and Pepi service(s) you received?

    To what extent do you agree or disagree with the following statement:
  • This field is for validation purposes and should be left unchanged.