Name 

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

Where did you hear about this opportunity? 
Did your baby/babies receive care in a neonatal unit in the UK?  
Thank you for your interest in taking part in this project, however, your neonatal experience must have been in the UK in order to be able to participate into this project.
Where did your baby/babies receive neonatal care?  
Which region of England did your baby receive neonatal care? 
Which of these options best describes your neonatal experience or experiences? 

Please select all that apply.

If you have had more than one baby admitted to neonatal care, please tell us about your most recent experience.

What level of care did your baby/babies receive?  

Please select all that apply.

At how many weeks gestation was your baby/babies born premature or sick? 

If you have had more than one baby admitted to neonatal care, please tell us about your most recent experience.

The following questions are optional. They enable us to monitor the diversity of the Oversight Group and help to 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 describes your connection to neonatal care? 
Which of the following best describes your ethnicity? 
How old were you when your baby/babies were born?

If necessary, please select multiple options if you had more than one baby born needing neonatal care and your age at their time of birth falls under a different age category.

Do you have a disability?
Which of these best describe your sexual orientation?
How do you feel you were managing financially when your first baby or babies needing neonatal care were born? 

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