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1. What gender were you assigned at birth?

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2. Are you pregnant or planning on getting pregnant?

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3. Do you have reason to believe you may be pregnant?

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4. Have you had a recent positive pregnancy test?

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5. If your pregnancy test is positive will you be sure to visit your GP to attend antenatal counselling and pregnancy planning?

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6. If you test positive for Hepatitis B or C will you be sure to consult your GP before engaging in any sexual activity?

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7. If you have had a recent high risk sexual exposure (including exposure to Syphillis, Hepatitis C or HIV) will you be sure to repeat an STI test in 6-8 weeks and use barrier contraception in the meantime?

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8. Are you aware that this test screens for HIV and that there is the possibility of a positive result?

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9. If your pregnancy test is negative but you continue to experience symptoms such as tiredness, swollen breasts, nausea or morning sickness will you be sure to visit your GP at your earliest convenience?

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10. Are you currently located in Australia?

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11. Do you understand everything that is written above or do you require assistance or language interpretation?

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