Pilot program

Staff Feedback

For physicians, nurses and other NICU staff who have used or distributed NICU Jargon Rx cards during a pilot. It takes about five minutes.

About your unit

Fields marked are required.

Your experience

How much do you agree with each statement?

1. The resource was easy to incorporate into our workflow.
2. The cards supported conversations with families.
3. The content and organization were easy for families to navigate.
4. The English/Spanish availability was useful for our patient population.
5. I would support continued use of NICU Jargon Rx on our unit.
In your own words

Optional. Please do not include patient names, medical record numbers, dates of birth or any other information that could identify a patient or family.

Contact details (optional)

Leave these blank unless you would like us to follow up with you.

This survey is intended for program-improvement feedback. Institutions should follow their own policies when collecting, storing, analyzing, or using feedback, particularly if activities may constitute research. Responses are stored by our website host, Netlify, and are accessible only to authorized NICU Jargon Rx personnel. Name and email are optional, but responses are not anonymous: your hospital, unit and role are recorded, and the host may record technical details such as IP address. See our Privacy Policy.