First Name First Name

Last Name Last Name

Your Age Your Age

Number of Children How many Children do you have?

How Many week Post Partum How Many week Post Partum At the Start of the course or Age of your Youngest child

List any Pelvic Floor or Birth Trauma List any Pelvic Floor or Birth Trauma prior to starting , eg: Grade 2 Prolapse, Diastasis, Hypotonic PF, Weak PF

How do you feel after 6 weeks? How did you want to feel after the 6 weeks, and did you get that Result?

What was the main reason you joined this course? What was the main reason you joined this course?

Do you now feel like that has been corrected? Or Needs more work? In the course or you will work on it yourself with the course content? Do you now feel like that has been corrected? Or Needs more work? In the course or you will work on it yourself with the course content?

Would you be likely to do a more advanced course now to continue? Would you be likely to do a more advanced course now to continue? Would you be likely to do a more advanced course now to continue? *Yes PleaseNo Thanks

How Did you find the Course Content? How Did you find the Course Content?

Was the content easy to follow, with clear instructions? Was the content easy to follow, with clear instructions?

How much Did you complete at home in your own time? All, Some , None? How much Did you complete at home in your own time? All, Some , None?

Why? Easier at home? Busy Life? Too Long Video, Too hard by yourself, Not motivated, Not interested? Preferred in person, or Zoom Live? Any feedback here...... Why? Easier at home? Busy Life? Too Long Video, Too hard by yourself, Not motivated, Not interested? Preferred in person, or Zoom Live? Any feedback here......

How Did your body feel prior to starting? Any emotions or feelings about your Body and Mind prior to starting? How Did your body feel prior to starting? Any emotions or feelings about your Body and Mind prior to starting?

How do you feel now? In comparison ? How do you feel now? In comparison ?

Any Feedback, Recommendations, Improvements or Changes or Suggestions to make this course better? Any Feedback, Recommendations, Improvements or Changes or Suggestions to make this course better?