Birthing From Within with Dawn Star Sarahs-Borchelt Class Evaluation

Date my class began *

Month Day Year

I am a:

Mother Father Partner Friend Relative Doula

My Mentor:

	1 = Never	2	3 = Rarely	4	5 = Usually	6	7 = Always
was engaging and approachable
gave clear answers and explanations
inspired self-confidence
facilitated lively discussions with parents
asked thought-provoking questions that made the process of making birth art meaningful

My comprehension of each of these pain-coping practices, based on my Mentor's instruction: (if your Mentor did not teach the pain-coping practice, leave that row blank)

	1 = Terrible	2	3 = So-So	4	5 = Good	6	7 = Excellent
Breath Awareness
Non-Focused Awareness
Finding the Center
Vocalizing/Co-chanting
Ovarian/Circular Breathing
Drugs & Epidurals
Footbath & Massage
Other

I rate my Mentor's capacity to build a pain-coping mindset by completing these statements, giving a number from 1 - 7, where 1 = no confidence, 3-4 = somewhat confident, and 7 = very confident. (If you are a birth companion [father, partner, friend, doula, etc.] rate your confidence in your aility to cope with and help the birthing woman in labor.)

When I started the class, my confidence in coping with pain was:

At the end of my classes, I rate my confidence in coping with pain as:

I rate how much I learned from and valued the following:

	1 = Totally Useless	2	3 = Somewhat Helpful	4	5 = Valuable	6	7 = Extremely Valuable
Practical Information
Birth Art (Labyrinth, Tigers, etc.)
Special Father's Class
"Getting Information" Role Play
Cesarean
Inanna Story
Warrior
Other

What I liked and/or valued most in the classes and why:

What I had the most trouble relating to during these classes was:

How these classes influenced my spouse's/partner's attitude towards labor, birth, and parenting:

How these classes influenced our relationship:

Anything else I want to share about the class, my Mentor, and/or my learning process:

Name (Optional)

First Name Last Name

You may use my name and comments publicly:

Yes