Result of treatment

You have been in treatment with us and had a good pregnancy ultrasound. We are very curious about how your pregnancy went afterwards. Of course we hope for a good outcome, but even if your pregnancy went differently and there are complications or abnormalities, we would like to hear from you.

Why do we need this information?

We believe it is important to measure, evaluate and report the outcome of our treatments. To accurately measure treatment outcomes, we ask that you complete the form below.

I am under treatment at *

Full name (mother): *

Date of birth (mother): *

Gender child: *

Born alive: *

Date of birth: *

Birth weight (grams): *

Child's name *

Congenital anomaly *

Comment

Comment:

Reporting another child

Gender child *

Born alive *

Date of birth: *

Birth weight (grams): *

Child's name *

Congenital anomaly: *

Comment

Comment:

Extra support

Do you need additional support as a result of this post? If so, please contact us. We are ready to help you.