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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 neonatal care? 

The following optional questions enable us to monitor the diversity of the Insight and Involvement Group 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?
Do you have a disability?
Which of the following best describes your ethnicity?

Your neonatal experience

Which of these best describes your neonatal experience or experiences?  

Select as many as apply.

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.

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

If necessary, please select multiple options if you had more than one baby born needing neonatal care and their gestation falls under a different gestation category.

At how many weeks gestation were you born premature or sick? 

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 Supporter Promise. If you have provided a postal address we may occasionally contact you by post, but you can opt out of all communications from Bliss at any time by calling us on 020 7378 1122 or emailing us.