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Teen Pregnancy

A document from Dawan National High School requests information from a pregnant student, including her name, age, address, parents' names, expected due date, and current grade and section. It asks her 5 questions about when she became sexually active, her current pregnancy situation, how the pregnancy happened and if it was planned, her sex education experience, and if the sex education at school was sufficient. The student is asked to sign confirming the information.

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Ivy Aguas
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22 views

Teen Pregnancy

A document from Dawan National High School requests information from a pregnant student, including her name, age, address, parents' names, expected due date, and current grade and section. It asks her 5 questions about when she became sexually active, her current pregnancy situation, how the pregnancy happened and if it was planned, her sex education experience, and if the sex education at school was sufficient. The student is asked to sign confirming the information.

Uploaded by

Ivy Aguas
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Department of Education

Region XI
Division of City of Mati

DAWAN NATIONAL HIGH SCHOOL


Dawan, Mati City, Davao Oriental

Name of pregnant student: _____________________________ Age:____ Religion:_______________


Name of her boyfriend/ live in partner:___________________ Grade & Section:
Mother’s Name:__________________ EDD:
Father’s Name:___________________ Status:
Address:_________________________

1. At what age did you become sexually active?

2. What is your current situation with pregnancy?

3. How did you come to be pregnant? Was the pregnancy planned?

4. Tell me, in your own words, about your sex education. ...

5. Do you feel that the sex education you received at school was sufficient?

_______________
Student Signature

IVY KATE G. TACDER


Clinic in charge

Noted by:
JANETH A. MAPA
School Guidance

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