Hello -

A North Central Washington health coalition is collecting information to assist with their work related to teen sexual health. This questionnaire is intended for any teen between 14 - 20 years of age who is being tested for a sexually-transmitted infection or pregnancy.  

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 STI or teen pregnancy testing questionnaire at an office visit, 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 Gender:

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