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  2. 2013
  3. February
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  5. Pill Texting
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Exit Survey
 
 
What is your race?
 
Caucasion
 
African American
 
American Indian
 
Asian
 
Other
 
 
 
 
What is your ethnicity
 
Hispanic or Latino
 
Not Hispanic or Latino
 
 
 
What is your age?
 
Under 18
 
18-2
 
21-25
 
26-30
 
31-40
 
41-50
 
Above 50
 
 
 
What is your marital status?
 
Single
 
Married
 
Divorced
 
Separated
 
Widowed
 
Other
 
 
 
 
Have you had a pregnancy within the last year?
 
Yes
 
No
 
 
 
If you answered yes to the previous question, was your pregnancy planned?
 
Yes
 
No
 
N/A
 
 
 
In the last month, how many birth control pills have you missed?
 
0
 
1-2
 
2-3
 
3-4
 
4-5
 
5 or more
 
 
 
If you miss taking birth control pills do you take two pills to make up for it?
 
Yes
 
No
 
N/A
 
 
 
Do you recieve text messages from Planned Parenthood reminding you to take your birth control?
 
Yes
 
No
 
 
 
If you answered yes, do you take your birth control pill within 30 minutes of getting a reminder text?
 
Yes
 
No
 
I have already taken my pill before I get the text