PHB Web Survey

1. Please complete the following information that will help Partners for Healthy Babies see who is visiting our site.

Zip Code:

Age:

Sex:

Female

Male

Ethnicity:

2. What best describes you?

Select one:

I am looking for information for myself

I am looking for information for someone else

I am a healthcare provider

3. Are you pregnant?

Select one:

Yes

Unsure

4. I think the information on this website is:

Select one:

Very helpful

Somewhat helpful

Not very helpful

5. I think this web site is:

Select one:

Easy to use

Somewhat easy to use

Not very easy to use

6. How did you find out about the PHB website?

Select one:

Television or Radio or Billboard

Print Material (flier, brochure, poster)

Baby Talk Newsletter

WIC

Another organization

A friend or family member

I called 1-800-251-BABY and they told me about the website.

I was searching the Internet and came across the website when I was looking for other information.