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ATTENTION: MOTHERS OR PREGNANT WOMEN
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PLEASE PRINT THE QUESTIONS AND EMAIL THE RESULTS TO ME
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1.What is your gender?
2.What is your age?
3.What is your annual income?
4.How frequently do you have sexual
intercourse within one week?
5.Do you use a method of birth control?
a. if yes, what kind?
6.Have you recieved any form of sex
education?
a. if yes from who or what did you
receive the information?
7.At what age did you first learn about
sex?
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8.Do you use any form of drug?
a. if yes, what kind?
b. how often?
9.Have you ever been pregnant?
a. if yes, how old were you?
b. did you keep the baby?
c. if no, what did you do?
10.If yes, did you recieve any prenatal
care?
a. if yes, when did you begin prenatal
care?
11.Did you attend lamaze classes?
12.Did you have any complications?
a. if yes, what were they?
13.What was the health of the baby at
birth?
14.How many children do you have?
15.What is your marital status?
16.What level of education have you completed?
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INFORMATION ABOUT ME
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This questionaire is for a class research project. Please answer and email me. I need at least 200 respondents.
Please help me out.
I will post the results sometime in May.
This is due at the end of April.
Thank you for any participation that I recieve.
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