Colorado pregnancy test 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the date at the top of the form. Next, fill in your name, address, city, state, phone number, and zip code.
3. Indicate your birth date and age. Then, mark your race and ethnicity as applicable.
4. Answer the question regarding your feelings about becoming pregnant by checking the appropriate box.
5. If you have any symptoms of pregnancy, indicate 'Yes' or 'No' and list any symptoms if applicable.
6. Provide details about your last menstrual period and whether it was normal. Include information on your last act of intercourse.
7. Select the method of birth control used from the provided options.
8. Respond to questions regarding interest in birth control methods if the test is negative and preferences if pregnant.
9. Complete additional personal health questions regarding past pregnancies, smoking habits, household size, and income.
10. Finally, sign and date the form to confirm your request for a pregnancy test.

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