Hello -

A North Central Washington health coalition is collecting information to assist with their work related to teen pregnancy. If you are a pregnant female between 13 and 20 years of age, you are invited to complete this questionnaire. 

Questionnaire responses are anonymous. No information is requested that will identify any individual participant. The data collected will be analyzed at the group level, not the individual level. If you completed a paper version of the teen pregnancy questionnaire at your physician's clinic, it is not necessary to complete this electronic version.  

Thank you for taking the time to complete this questionnaire.


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* 1. Your Age:

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* 2. Your Race/Ethnicity: (please check one)

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* 4. Is this your first pregnancy?

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* 5. Was this pregnancy planned?

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