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1. Are you sexually active?

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2. Did you have sex without a condom anytime since the last day of your last period?

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3. Are you on any form of contraceptive?

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4. Did you miss your recent period? (Required.)

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5. By how many days have you missed your period? (Required.)

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6. Are you always tired? (Required.)

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7. How do your breasts feel? (Required.)

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8. Do you have any cramps?

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9. Have you been bloated lately?

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10. Have you had any cravings?

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11. Have you been experiencing any sickness, nausea and/or vomiting?

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