About you

Name 

We'll only use this to contact you with relevant information and if you opt-in to receive other Bliss updates.

Which of these best describes your connection to Bliss? (Please select all that apply) 
Which of these best describes your neonatal experience or experiences?  

Select as many as apply.

Please give your baby/babies’ gestational ages at birth if you are happy to / if applicable to you.

How do you feel you were managing financially when your first baby or babies needing neonatal care were born? 
Where did you hear about this opportunity to help shape Bliss' brand? 

Diversity monitoring

The following optional questions enable us to monitor the diversity of our audience insights panel and ensure that it is representative of all families who experience neonatal care.

Which of these best describes the gender you identify with?
Which of these best describe your sexual orientation?
Which of the following best describes your ethnicity?
Do you have a disability?

Let's keep in touch

Your support helps the most vulnerable babies in the UK. We’d love to keep you updated with news about our work and ways you can get involved with Bliss.
By email
By phone
By text

Your privacy


We (Bliss and Bliss Scotland) promise to keep your details safe and never pass them on to third parties for marketing purposes. Find out how we look after your personal data in our Privacy Policy. If you have provided a postal address we may occasionally contact you by post. You can opt out of all communications from Bliss at any time by calling us on 020 7378 1122 or emailing us.