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2005
December
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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be stricly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.
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Should it be possible for a womon to obtain a legal abortion if the pregnancy interferes with pursuit of her future goals
Yes
No
Don't know
*
Shoud it be possible for a woman to obtain a legal abortion if she wants for any reason
Yes
No
Don't know
*
Should it be possible for a woman to obtain a legal abortion if there is a strong chance of a serious defect in the baby
Yes
No
Don't know
Should it be possible for a woman to obtain a legal abortion if her own healthis endagered by pregnancy
yes
no
don't know
Should it be possible for a woman to obtain a legal abortion if she is married as does not want anymore children
Yes
No
Don't know
Shoud it be possible for a woman to obtain a legal abortion if the family has a very low income and cannot afford anymore children
Yes
No
Don't Know
Should it be pssible for women to obtain a legal abortion if the pregnacy is a result of rape
Yes
No
Don't Know
Additional Comments/Suggestions for improvement
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[email protected]
if you have any questions regarding this survey.
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