Tandem Feeding Questionnaire

Your name *

First

Last

What are your preferred pronouns for yourself and your family?

Your email address *

Your telephone number *

By providing your 'phone number you are consenting to being added to the Tandem Feeding Whats App Group

Your address *

What is the name of your partner/supporter?

First

Last

What is your relationship to your named partner/supporter?

E.g. husband, wife, partner, friend, parent, etc.

What are your children's names? And how old are they?

Tell us a little about your tandem feeding journey...

Are there any health concerns for you or your baby?

E.g. Previous breast surgery, fertility or hormonal concerns, heart conditions, diabetes, tongue-tie or other oral concerns.

Are there any other services or professionals you as a family are currently working with? *

For example; Early Help, Perinatal Mental Health, Childrens Social Care, Home Start, Your Family, Infant Feeding Team etc.

If you have selected YES to the above question, please let us know which services or professionals you are currently work with.

Is there anything else you'd like to share with us?

Thank you for taking the time to complete the questionnaire, I know it is quite long! The more detail I have prior to the session means the more time we can focus on tools and techniques for you.

By completing and submitting this questionnaire you are giving permission for The Milk Hub to collect and process the above information including any personal information as defined under GDPR regulations, and in line with both our legitimate interests. All information you supply is held in the strictest confidence and not shared with any third parties without your consent. The only exception to this is if we are required to disclose information to another agency or service in line with a safeguarding concern. Completing and submitting this questionnaire also acknowledges that you accept the Privacy Notice, Terms and Conditions and Safeguarding Policy listed on The Milk Hub website. *

I agree

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