Healing a Miscarriage- Survey

BASIC INFO

Full Name:*

First NameLast Name

E-mail:*

Phone Number*

Area CodePhone Number

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Current Age Range:*

Ethnicity:*

Occupation:*

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Thank you in advance for answering the questions below. Please take your time with this survey...it has the potential to further your healing as well as gather info to support others in their healing process too.

With Love,

Elyse Falzone

*** Please note this information will remain anonymous unless otherwise agreed upon.

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PHYSCIAL

How many miscarraiges have you experienced?*

At what ages were you when you experienced these miscarraiges?*

Was this your first pregnancy? If not, how many pregnancies did you have prior to experiencing the miscarriage? Were they healthy pregnancies?*

At what stage in the pregnancy/pregnancies did the miscarriage occur? (Ex: Week 7, Week 12, etc)*

Did you experience a Natural Release or did you have a D&C Procedure? Please explain/ Share your experience.*

Please decribe how the pain level was and how your related to the pain. (Pain of cramping, surgery, body...)*

How long did you bleed for? *

Did you have any complications through this process?*

What tools, resources or exercises did you use to support you during your physical healing?*

EMOTIONAL

What emotions did you experience during this process? Before, During & After (Ex: excited, hopeful and then grief, sadness, shame, anger...)*

What were your needs durning that time? (Ex: needed to cry, wanted to be alone, wanted hugs...)*

Had you announced to the world you were pregnant prior to finding out about miscarriage? Or was it only you or a select few that even knew you were pregnant?*

Once the loss occured, did you tell people? Or did you keep it quiet? WHY? Please share.*

How did people respond? *

How did you want people to respond or support?*

How did you handle this experience with work/your job? Did you take time off during the miscarriage or anytime after for healing? Why or why not?*

Do you feel like you had time to heal or you gave yourself time to heal? Why or why not?*

Did you have a significant other or spouse with you during this process? Or were you single at the time?*

If you did have a significant other with you... how did this person respond to the miscarriage process? Were you aware of their needs during the time? Were they aware of your needs? Do you feel they have healed? Please explain.

If you were single at that time... what was this experience like for you? Did you find someone/people who became your support system?

Did you already have children when a miscarriage occured? If so, how were they impacted?

What tools, resources or exercises did you use to support you during your emotional healing?*

SPIRITUAL

Do you have a belief in a Higher Power? If so, what do you call it?*

During your time of loss, what was your experience with the Higher Power?*

What did you notice about your "Spiritual Self" around the time of miscarriage?*

Did you notice your "Spiritual Self" needing anything during this time?*

What LESSONS, if any, did you learn by going through the miscarriage experience?*

What tools, resources or exercises did you use to support you during your spiritual healing?*

YOU'RE ALMOST THERE!

Have you had any children/successful pregnancies since the miscarriage? *

Do you feel like you have healed? Or do you feel like there is still healing to take place?*

Do you ever share or talk about your experience?*

What is your relationship to your body?*

What current habits support you in nourishing your body, mind and soul?*

Are you interested in learning about how to nourish your body, mind and soul?*

If you could give advice or share a lesson with a woman currently experiencing a miscarriage... What would you say to her?*

Are you open to having your story (or parts of your story) shared publicly?

YesYes to story - please keep my basic info (name, specifics) anonymousNo Thank You

Anything else you wish to share?

You are beautiful. You are radient. You are a gift. ALWAYS remember this!

Thank you again.

Elyse

Enter the message as it's shown*

Awaken Your Soul

Elyse Falzone

Email: elyse@awakenyoursoulglobal.com

IG: _awakenyoursoul

FB: www.facebook.com/awakenyoursoulglobal

Healing from a Miscarriage