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Circle of Hope/Birth Mother's Network Survey

The National Organization on Fetal Alcohol Syndrome (NOFAS) is seeking to collect anonymous information from women who have used substances while pregnant, or who have children with fetal alcohol spectrum disorders (FASD). By completing this survey you will help NOFAS provide information to healthcare providers, so they are better able to prevent FASD, and help individuals and families affected by FASD. Thank you—your input is invaluable!
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What is your current age?(Required.)
What state/territory do you live in? (Required.)
What is the highest grade you completed in school?(Required.)
How do you describe yourself?(Required.)
What is your current family income?(Required.)
How many times have you been pregnant? (Do not list pregnancies that were terminated)(Required.)
Has any one ever talked with you about the effects of drinking alcohol during pregnancy? (Required.)
If you answered yes to question 7, who talked with you about the effects of drinking alcohol during pregnancy?(Required.)
Which substance has the most harmful impact on the baby if used during pregnancy? (Choose only one answer) (Required.)
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