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FIMR Home Interview

The purpose of this program is to identify factors associated with fetal and infant deaths and to find ways to help families in the future.  To achieve these goals, we wish to interview mothers who have recently experienced the loss of a fetus or infant.  We would like to invite you to participate in an important program to better understand why these tragedies happen.  We understand that sometimes there are no answers to why these sad events occur.  However, if you will share your information it will be used to help reviewers develop recommendations for change and help put those changes into action.  The mother’s input has proven to be crucial for changing the community for the better.


We hope that you will choose to take part in the program.  By doing so, you may help improve the services and care for all mothers and babies in Leon and neighboring counties.  If you would like to help us and others, please call 850.488.0288 ext. 106 or complete the form below to schedule an interview.  You may also contact us so we can set up a time for grief counseling with a local grief support resource.

Information About The Home Interviews

My Name:

Please Contact Me Soon.

Please Contact Me In 4 to 6 Months.

I Do Not Wish To Participate In The Project.

Baby’s Name:

My Phone Numbers Are:

Home:

Cell:

Work:

My Email Address Is:

The Best Time To Call Me Is:

My Correct Address Is:

Street Address:

City, State, and Zip Code:

Please Select One of the Following: