Name First Last This field is hidden when viewing the formEmail (optional) This field is hidden when viewing the formYour Client ID (optional)Which of these best describes you?* I am a current AFMC client I am a former AFMC client What state are you from?AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificWhy did you cancel your membership with AFMC?* I/We matched with one of AFMC's available situations I/We matched with an expected mother who contacted me through your website I/We matched through my adoption agency I/We matched through my adoption attorney I/We matched through my adoption consultant I/We matched independently without the use of an adoption professional Other How likely are you to recommend AFMC to others?*Please selectDefinitely Would RecommendProbably Would RecommendNeutralProbably Would Not RecommendDefinitely Would Not RecommendHow would you rate your overall experience with AFMC?*Please selectExtremely PositiveVery PositivePositiveNeutralNegativeVery NegativeExtremely PositiveHow long did it take you to successfully match with AFMC?*Please select0 - 3 months4 - 6 months7 - 9 months10 - 12 months13 - 18 months19 - 24 monthsOver 2 yearsHow long have you been waiting to adopt (overall)?0 - 3 months4 - 6 months7 - 9 months10 - 12 months13 - 18 months19 - 24 months2 - 3 Years3 - 4 Years4 - 5 yearsMore than 5 yearsWhat made AFMC service stand out from other options?What was your deciding factor for using AFMC?Was there anything we could have differently?Is there anything else that you would like to comment on or say about AFMC?Testimonial/Review of AFMCMay be shared publicly on AFMC's social media accounts and website.Share Publicly* Yes - please send consent No Yes - but no video or photos please. Shared on website, social media and marketing material.Photos - Optional Drop files here or Select files Accepted file types: jpg, png, tiff, svg, Max. file size: 40 MB. We'd love to share some photos of your new family with your testimonial. Video/Audio Recording - Optional Drop files here or Select files Accepted file types: mp4, mpeg-4, 3gp, Max. file size: 128 MB. Video or Audio recording to go with slide show of your adoption journey. How should we refer to you on your testimonial? First Name Only Anonymous Former Client May we use you as a former client reference if a potential new client has questions? Yes No How should we have them contact you? Select All Phone Text Email No Contact Please None of your contact information will be shared publicly. You will also know ahead of time that someone may be reaching out to you with questions. Phone Number(Will NOT be posted publicly)
