Abortion Survey

1. Are you male or female? male female
2. Which age group do you belong to? under 18 18-35 over 35
3. What is your marital status? single married widow/widower divorced
4. Which geographic area are you from? Africa Asia Australia Canada Central America Central U.S. Europe India Middle East Northeastern U.S. Northern U.S. Northwestern U.S. Polynesia South America Southeastern U.S. Southern U.S. Southwestern U.S. Other
5. If you are from the United States, which political party best represents your belief systems? Democratic Republican Libertarian Reformist Other
6. Which best describes your family's annual income? under $10,000 under $20,000 under $30,000 under $40,000 $40,000 or more
7. Which best describes your education level? junior high (grade 7-9) high school (grade 10-12) college (1st thru 4th year) graduate (past 4th year) other
8. When do you believe life begins? at conception at implantation 4 weeks after conception 6 weeks after conception 2 months after conception 3 months after conc. 4 1/2 months after conc. at "viability" 6 months after conc. 9 months after conc. at birth later
9. Please select a statement from the list below which best represents your position on abortion a. Abortion should be illegal in all circumstances b. Abortion should be legal only to save the mother's life c. Same as b., but including rape or incest d. Abortion should be legal for any reason d. Other (please explain in comment section)
10. Do you oppose all health care legislation, federal or state, which includes abortion coverage as a benefit? Yes No Unsure
11. Do you oppose all health care legislation, federal or state, which includes rationing health care? Yes No Unsure
12. Would you be willing to utilize the power of your vote to:
    • Prohibit abortion as a means of birth control? Yes No Unsure
    • Prohibit abortions, except to save a mother's life? Yes No Unsure
    • Prohibit abortions, except to save the mother's life, or in cases of rape or incest? Yes No Unsure
    • End state abortion funding, except to save the mother's life? Yes No Unsure
    • End state abortion funding, except to save the mother's life, or in cases of rape or incest? Yes No Unsure
    • Require parental consent before a minor can have an abortion? Yes No Unsure
    • Require a participatory role for the baby's father in an abortion decision? Yes No Unsure
    • Require that women facing abortion be informed of the possible psychological and medical risks, alternatives, and facts on fetal development? Yes No Unsure
    • Prohibit infanticide of babies with disabilities? Yes No Unsure
    • Prohibit active euthanasia? Yes No Unsure
    • Prohibit the withdrawal of food and water from any medical patient? Yes No Unsure
    • Prohibit the withdrawal of food and water from any terminally ill patient? Yes No Unsure

Thanks for taking the time to fill out this survey! Comments or suggestions are welcome. If you have a question or would like to discuss an issue, please leave me your e-mail address below, and I'll try to get back with you as soon as I can.

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