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* 1. Name:

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* 2. What age category are you in?

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* 3. What gender are you?

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* 4. Chlamyida and Gonorrhea are curable with prescribed medicine.

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* 5. Gardasil is a vaccine that helps prevent human papilloma virus (HPV).

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* 6. Over 75% of people will exhibit a sign or symptom when they have an STI.

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* 7. HIV stands for human immunodeficiency virus.

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* 8. What are the 3 progression stages of syphillis?

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* 9. Hormonal  contraceptives help protect me against STIs.

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* 10. What is 1 thing you learned in the STI 101 presentation?

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* 11. How did you hear about Midtown Health Center?

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* 12. If you would like to be entered into the drawing for a gift card, please leave your contact information below!

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