Customer Insights Survey Step 1 of 14 7% *We wish to continue being able to support women globally.* Getting to know the women we assist can help safe2choose improve services for others who are seeking access to safe abortion. In order to accomplish our mission, we are inviting clients to answer a small questionnaire. Your answers will be used for statistical purposes only and your personal information will remain strictly confidential. It should take no more than 5 minutes and is optional. We thank you in advance for your time and wish you the best. safe2choose team How old are you?*13 or younger14151617181920212223242526272829303132333435363738394041424344454647484950 or more How many children do you have?*01234 or more What is your religion?*BuddhisnHinduismJudaismChristianityIslam Highest level of education completed.*Nothing on recordPrimary schoolSecondary schoolProfessional vocational programUniversity / Bachelors degreeMasters / Law degreeDoctor or PhD How would you best describe your current occupation?*StudentFull-time employeePart-time employeeSelf employedUnpaid houseworkRetiredUnemployed What type of setting do you live in?*Inside city / urbanEdge of city / semi-urban / suburbanOutside city / farmland / rural What is your family's monthly income?**USD $MXN $GBPEuro What is your relationship status?*SingleHave a partnerMarriedWidowedDivorcedSeparated Who decided you should have this abortion?*MyselfMy partner and IMy family and IMy partnerMy family What made you choose ordering abortion pills online? Please mark the alternative that best fits your case*Affordability - I couldn’t pay for any other optionAvailability - I didn’t know anyone or any institution where I could have a different methodPrivacy - no one will know besides me and those I trust to support me.Convenience - easy to order and do from my own homeIt was the method I felt more comfortable with If you feel comfortable, please share why you decided to have an abortion. Check all that apply options Health reasons I feel I am too young to have a child right now I already have as many children as I want to have My youngest child is too young for me to have another baby I do not want to have children I want to delay having another child I am concerned about Zika virus (I have been diagnosed with/exposed to zika virus) I am not ready for the responsibility of having a child I am not prepared to have another child right now Having a child would interfere with my education Having a child would change my life in ways that I do not want My family would not accept this pregnancy My partner would not accept this pregnancy I am facing problems in my relationship I do not want to be a single mother I want to be married before having a child I do not want my family/others to know about this pregnancy This pregnancy results from a rape Other I wouldn't mind to answer additional questions on how I felt while answering this survey*YesNo Did any of the questions on our survey make you feel uncomfortable?*YesNoWhich question(s) made you uncomfortable?* How old are you? How many children do you have? What is your religion? Highest level of education completed How would you best describe your current occupation? What type of setting do you live in? What is your family's monthly income? What is your relationship status? Who decided you should have this abortion? What made you choose ordering abortion pills online? Why you decided to have an abortion Were the questions easy to understand?*YesNoWould you recommend us adding any other questions that you think would help us better understand our clients?* This iframe contains the logic required to handle Ajax powered Gravity Forms.