Family Planning Survey Questionnaire
Family Planning Survey is done to check the awareness of the people regarding the family planning methods. Family Planning Survey Questionnaire is given to the married couples who should have knowledge about family planning procedures. Solving this questionnaire does not just check their knowledge but also helps them learn a number of things on the subject.
Sample Family Planning Survey Questionnaire
Name of the Participant: _____________________
Date of Birth: ____/____/____
Address: ____________ City: ___________ State: ___________ PIN: _____________
Phone Number: ______________
Email Address: _____________________
What is your gender?
Are you married?
Since how long have you been married?
a) Less than a year
b) 1 to 2 years
c) 2-5 years
d) More than 5 years
Are you planning a family?
Have you consulted a doctor for having a discussion about family planning?
Are you and your partner taking any preventive measures for refraining from getting pregnant?
What preventive measures are you and your partner taking for avoiding unplanned pregnancy? (Select from the below mentioned options)
f) Tubes tied
In case you are not taking any measures for avoiding pregnancy then please select an appropriate reason for the same out of the ones mentioned below?
a) Too Old
b) Breast feeding
d) Can’t afford
When are you planning to have a child?
a) Within 1 year
b) After 1 year
c) After 2-3 years
d) After 5 years
Have you heard about the free family planning services?
If the answer to the above mentioned question is ‘Yes’ then please specify as to where you have heard it from.
Category: Planning Questionnaire