CONI feedback form

It is really helpful to us to get the views of parents who have used our Care of Next Infant (CONI) programme. We hope you will complete this questionnaire to give us your opinion on the programme. It will only take you 10 minutes and your answers will help us to improve the programme for other parents.

Where in the UK do you live?*

Support elements of CONI

Please tell us about the elements of CONI you used and how helpful you found them.

We would like to know what elements of the CONI programme you used and how helpful you found them

Symptom diary

Never used
Used sometimes
Used a lot

How helpful did you find it?

Monitor

Never used
Used sometimes
Used a lot

How helpful did you find it?

Which monitor did you use?

How helpful did you find it?

Weight chart

Never used
Used sometimes
Used a lot

How helpful did you find it?

Room thermometer

Never used
Used sometimes
Used a lot

How helpful did you find it?

Baby check app

Never used
Used sometimes
Used a lot

How helpful did you find it?

Which elements of the CONI programme are you still using? (tick as many as you like)

Symptom diary
Monitor
Weight chart
Room thermometer
Baby check book or app (only up to 6 months old)

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I feel more at ease with and more positive about my family because of the support I received from CONI

Strongly Agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

Support visits / Contact

Were you happy with the number of visits/contacts you received?

Yes
Yes at first, then too frequent
Yes at first, then did not visit me enough
No, they did not visit me enough
No, they visited me too often

Where did you have your visits/contacts?

How helpful did you find them?

In what ways did you find the visits/contacts helpful?

What was your experience of using the Paediatric Passport? Please tell us

Safer Sleep

Were you given practical advice about safer sleep and reducing the risk of SIDS?

Yes
No

Where did your baby sleep during last night?

Own cot/sleep place
In your bed
Somewhere else

Where did your baby wake up this morning?

Own cot/sleep place
In your bed
Somewhere else

Final Comments

I feel better able to cope with anxiety about my baby's health because of the support I received from CONI

Strongly Agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

I feel less isolated as a result of the support I received from CONI

Strongly Agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

I feel more able to cope with life in general because of the support I received from CONI

Strongly Agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

What is the likelihood that you would have consulted your GP more often if you had not have support from CONI?

What is the likelihood that you would have attended A&E more often if you did not have support from CONI?

In summary, how helpful have you found the CONI programme?

Please tell us your thoughts in general about your CONI experience?

Can we use your comments anonymously for any of the below purposes?

Tick as many as apply

Training
Fundraising for CONI
Feedback to CONI Co-ordinators
Lullaby Trust Publications

Please can you tell us your name?*

Please can we have your email address?*

Keeping in touch

At The Lullaby Trust, we’re determined to do all we can to save more lives. We can’t do this without the help of our supporters, which is why we’d like to keep in touch with you about our vital work, news and opportunities to support us.

Please confirm below how you want to hear from us in future

Email*

Email

Post*

Address

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

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Would you like the opportunity to receive an invite to attend an annual free Family Day in your region?

Yes
No

Thank you so much for taking the time to give us your feedback. Your answers will be used to monitor the effectiveness of the CONI programme and to make improvements to it for future parents.

If you need any support and would like to talk to someone, we are here for you. You can call our Bereavement Support Helpline on: 0808 802 6868 (weekdays 10.00am - 5:00pm 00 and weekends 6:00pm – 10.00pm) or email: [email protected]

Please also see our Privacy Policy for how we collect, use and look after your information.

Number

Phone

This field is for validation purposes and should be left unchanged.

Support elements of CONI

Support visits / Contact

Safer Sleep

Final Comments