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  5. Demographic Questionnaire 2
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What is your field of nursing?
   
 
 
 
What is your age?
 
25 or under
 
26-40
 
41-55
 
56 or older
 
 
 
What is your gender?
 
Male
 
Female
 
 
 
How would you classify yourself?
 
Arab
 
Asian/Pacific Islander
 
Black
 
Caucasian/White
 
Hispanic
 
Latino
 
Multiracial
 
Other
 
 
 
What is your current marital status?
 
Divorced
 
Living with someone
 
Married
 
Separated
 
Single
 
Widowed
 
Other
 
 
 
Do you have any children?
 
Yes
 
No
 
 
 
Do you know of someone who is either a relative or friend who is pregnant?
 
Yes
 
No
 
 
 
Would you provide assistance in administering a medical or surgical abortion?
 
Yes
 
No
 
Undecided
 
Rather Not Say