2017 Workplace Breastfeeding Survey Order Number In celebration of World Breastfeeding Week August 1 -7, 2017, the Breastfeeding Coalition of Snohomish County will be recognizing employers within Snohomish County. We are gathering information about breastfeeding policies and support in local workplaces. Please take this short survey, sharing what your workplace is doing to support breastfeeding. Submit by June 30. Thank you! Employer Name * Employer Address * Employer Phone * Employer Website 1. Does your employer describe their breastfeeding support in a verbal and/or written policy? * Yes No 2. Does your employer provide you with a secure/private location to express milk? * Yes No 3. Does your employer support continued breastfeeding? * Yes No If yes, please check all that apply. Flexible break schedule for employees needing to express milk Ability to work part-time or some hours from home Flextime or job-sharing options On-site childcare “Baby-at-work” program Maternity leave Employer paid maternity leave (not including vacation, or sick time) Paternity leave Other Other (please explain) 4. Does your employer provide you with information about local breastfeeding resources? * Yes No 5. Do you have any additional comments you would like to make about your experience with your employer regarding accessibility and friendliness towards breastfeeding and/or pumping? Thank you for taking the time to complete this questionnaire. The information you have provided will assist the Breastfeeding Coalition of Snohomish County in recognizing employers that support breastfeeding.
