Women's Health Needs STUDY_QUESTIONNAIRE

Attachment H2. Women’s Health Needs Study Questionnaire (Somali translations)

Full Questionnaire			Foomka Su'aalo waydiinta oo Dhamaystiran
	Cover Page	Public reporting burden of this collection of information is estimated to average 45 minute per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).		Jaldigga Foomka	Wargalinta dadwaynaha ee aruurinta macluumaadkaan waxaa lagu qiyaasay celcelis ahaan 45 daqiiqo jawaabtiiba, ayna kujiraan waqtiga dib u eegista lagu samaynaayo tilmaamaha, raadinta ilaha macluumaadka ee horay ujiray, aruurinta iyo ilaalinta macluumaadka loobaahanyahay, iyo dhamaystirka iyo dib umuraajacaynta aruurinta macluumaadka. Waxaa suuragal ah inaan wakaalad fulin ama maalgalin, qofkana lagama doonaayo inuu jawaab kabixiyo su'aalaha macluumaad aruurinta ilaa inay muujinayso maahee nambarka saxda ah ee an wali dhicin ee maaraynta OMB. Udir fikradaha laxariira qiyaasta cadayntaan ama waxkasta oo laxariira mawduucaan ayna kujiraan soojedinada laxariira yaraynta culayskaan una gudbi Madaxa Kalahufida Warbixinada ee CDC/ATSDR; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).
	OMB notice	Form Approved		Ogaysiiska OMB	Foomka La ansixiyay
		OMB Number:			Nambarka OMB:
		Expiration Date:			Taariikha Dhicitaanka:
	Survey Title	Women's Health Needs Study		Ciwaanka Sahanka	Daraasada Baahiyaha Caafimaad Haweenka
SECTION B. BACKGROUND CHARACTERISTICS			QAYBTA B. ASTAAMAHA ASAASIGA AH EE QOFKA
	Intro	Now we can begin. I am going to start by asking you some basic questions about your background.		Isbarasho	Hadda waan bilaabi karnaa. Waxaan doonayaa inaan kubilaabo anoo kuwaydinaaya su'aalo dhawr oo aasaasi ah kuna saabsan noloshaada.
	Q1	What languages do you speak comfortably now?		Su'aasha 1	Luuqadee ayaad sifiican ugu hadashaa?
	Q2	Do you speak a language other than English at home?		Su'aasha 2	Makuhadashaa luuqad aan Af-Ingiriisi ahayn?
		Yes No [GO TO Q4] Prefer not to answer [GO TO Q4]			Haa Maya [UGUDUB SU'AASHA 4] Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 4]
	Q3	What is this language? [Specific languages will vary by country of origin].		Su'aasha 3	Luuqadaani waatee [luuqadaha gaarka ah waykaladuwan yihiin sida wadamadu ukaladuweanyihiin].
	Q4	What language(s) do you speak most often with your closest friends? [INTERVIEWER NOTE: Allow for two languages to be given]		Su'aasha 4	Luuqadahee ayaad kuhadashaa inta badan markaad lahadlayso saaxiibadaada kuudhaw? [OGAYSIISKA WARAYSTAHA: U ogoloow in qofku laba luuqadood sheego]
	Q5	If you think of yourself as belonging to a particular ethnic group or tribe, what would that be?		Su'aasha 5	Hadaad aaminsantahay inaad qoomiyad gaar ah ama qabiil gaar ah ku abtirsato, waa qabiilke?
		Don’t Know Prefer not to answer			Ma aqaano Madoonaayo inaan kajawaabo
Skip logic		[SKIP LOGIC: IF RESPONDENT WAS BORN IN THE U.S. (SCREENER Q4), GO TO Q8]	Iskagabood		[ISKAGABOOD: HADDII QOFKU KUDHASHAY MARAYKANKA. (BAARAHA SU'AASHA 4), [UGUDUB SU'AASHA 8]
	Q6	In what year did you first move to the United States?		Su'aasha 6	Sanadkee ayaad markii ugu horaysay usoo guurtay Maraykanka?
		• Within the last year • 1-5 years ago • 6-10 years ago • Over 10 years ago • Don’t Know • Prefer not to answer			• Sannadkii u dambeeyay guddahiisa • 1-5 sano kahor • 6-10 sano kahor • In ka badan 10 sano ka hor • Ma aqaano • Madoonaayo inaan kajawaabo
	Q7	Since moving to the United States, how many times have you traveled home? “Home country” is the country where you were born or where you lived most of the time before coming to the U.S.		Su'aasha 7	Ilaa markaad usooguurtay Maraykanka, meeqa jeer ayaad wadankaagii hooyo usafartay? "Wadanka Hooyo" waa wadanka aad kudhalatay ama aad intaada badan kunoolayd kahor intaadan Maraykanka imaan.
		• Never • Once • 2-3 times • Four or more times • Don’t know • Prefer not to answer			• Marna • Halmar • 2-3 jeer • Afar jeer ama kabadan • Ma aqaano • Madoonaayo inaan kajawaabo
		GO TO Q9			UGUDUB SU'AASHA 9
	Q8	How many times have you traveled outside the U.S.?		Su'aasha 8	Meeqa jeer ayaad usafartay banaanka wadanka Maraykanka?
		• Never • Once • 2-3 times • Four or more times • Don’t know • Prefer not to answer			• Marna • Halmar • 2-3 jeer • Afar jeer ama kabadan • Ma aqaano • Madoonaayo inaan kajawaabo
	Q9	In what country does your mother live now?		Su'aasha 9	Wadankee ayay hooyadaa hadda kunooshahay?
		• Mother passed away [GO TO Q11] • Don’t Know [GO TO Q11] • Prefer not to answer [GO TO Q11]			•Hooyo waa dhimatay [UGUDUB SU'AASHA 11] • Ma aqaano [UGUDUB SU'AASHA 11) Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 11]
	Q10	How often do you speak with your mother?		Su'aasha 10	Intee jeer ayaad lahadashaa hooyadaa?
		• Daily • 2-3 times a week • Once a week • Once/twice a month • Less than once a month • Never • Don’t Know • Prefer not to answer			• Markasta • 2-3 jeer asbuucii • Halmar asbuucii • Halmar/labo jeer bishii • Waxkayar halmar bishii • Marna • Ma aqaano • Madoonaayo inaan kajawaabo
SECTION C. MARRIAGE AND HOUSEHOLD			QAYBTA C. GUURKA IYO QOYSKA
intro		Next, I am going to ask you questions about your marital status and living arrangements.	isbarasho		Qodobka xigga, waxaan doonayaa inaan wax kaawaydiiyo gurkaaga iyo qaabkaad unooshahay.
	Q11	Including yourself, how many people live in your household now? Please count children and elders. Do NOT count visitors. A visitor is someone staying in the home for less than one month.		Su'aasha 11	Adoo naftaada kabilaabaaya, meeqa qof ayaa kunool gurigaaga hadda? Fadlan tiri caruurta iyo dadka waawayn. Dadka kusoo booqda tirada hakudarin. Qof kusoobooqda waa qof gurigaaga jooga waxkayar muddo bil ah.
		• Don’t Know • Prefer not to answer			• Ma aqaano • Madoonaayo inaan kajawaabo
	Q12	Which of the following describes your current marital status? Are you married, living with a partner, widowed, divorced, separated, or have you never been married?		Su'aasha 12	Midkee kamid ah qodobada soosocda ayaa qeexaaya xaaladaada guurka? Mawaxaad tahay qof xaas leh, lamaane lanool, xaaskii kadhintay/dhimatay, garoob ah/xaaskii ay isfureen, kalatageen, ama waligaaba maadan guursan?
		• Married • Not married, but living with a partner [GO TO Q16] • Widowed • Divorced • Separated • Never married [GO TO Q16] • Prefer not to answer [GO TO Q16]			• Guursaday • Maguursan, waxaan lanoolahay lamaane (UGUDUB SU'AASHA 16) • Xaaskii wuu dhintay • Waa isfurnay • Waa kalatagnay • Waligay maguursan (UGUDUB SU'AASHA 16) Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 16]
	Q13	How old were you when you first got married?		Su'aasha 13	Meeqo sano jir ayaad ahayd markii koobaad ee aad guursatay?
		• Under 18 years • 18-24 years • 25-29 years • 30-39 years • 40-49 years • Over 49 years • Don’t Know • Prefer not to answer			• Ka yar 18 sanno • 18-24 sano kahor • 25-29 sano kahor • 30-39 sano kahor • 40-49 sano kahor • Ka badan 49 sanno • Ma aqaano • Madoonaayo inaan kajawaabo
	Q14	How old was your husband when you first got married?		Su'aasha 14	Meeqo sano jir ayuu ahaa ninkaagu markii koobaad ee aad isguursateen?
		• Under 18 years • 18-24 years • 25-29 years • 30-39 years • 40-49 years • Over 49 years • Don’t Know • Prefer not to answer			• Ka yar 18 sanno • 18-24 sano kahor • 25-29 sano kahor • 30-39 sano kahor • 40-49 sano kahor • Ka badan 49 sanno • Ma aqaano • Madoonaayo inaan kajawaabo
	Q15	In what country did your first marriage take place?		Su'aasha 15	Wadankee ayaad marka koobaad kuguursatay?
SECTION D. EFFECTS ON MIGRATION			QAYBTA D. SAAMAYNADA SOOGALOOTIGA
intro		I am now going to ask you some questions about your participation in community activities such as neighborhood organizations or groups.	isbarasho		Hadda waxaan rabaa inaan dhawr su'alood kaawaydiiyo kaqaybgalkaaga hawlaha bulshada sida ururada ama kooxaha xaafadaada kajira.
	Q16	Are you a member of any club or association for people from your family’s home country or ethnic/cultural background?		Su'aasha 16	Xubin makatahay koox ama urur ay leeyihiin dadka kasoo jeeda wadankaaga hooyo ama qoomiyadaada/iskudhaqan aad tihiin?
		• Yes • No • Not sure • Prefer not to answer			• Haa • Maya • Mahubo • Madoonaayo inaan kajawaabo
	Q17	When you invite people to your home, are they usually people from your family’s home country or ethnic/cultural background, or with people who are NOT from your family’s home country or ethnic/cultural background?		Su'aasha 17	Markaad dadka gurigaaga kucasuunto, inta badan madad ayimaadaa wadankaagii hooyo ama qoomiyadaada/dadka aad iskdhaqanka tihiin, mise waa dadka aan ka imaan wadankaagii hooyo ama ad isku qomiyada/dhaqanka tihiin?
		• Mostly people from my home country or ethnic/cultural background • Mostly people NOT from my home country or ethnic/cultural background • A combination • I never invite people to my place • Prefer not to answer			• Inta badan waa dadka wadankayga hooyo kasoojeeda ama iskuqoomiyada/dhaqanka aan nahay • Inta badan waa dadka wadankayga hooyo AAN kasoojeedin ama iskuqoomiyada/dhaqanka aan nahay • Qolo walba • Waligay dad kumacasuumin gurigayga • Madoonaayo inaan kajawaabo
	Q18	Have you done any work outside of the home for pay in the past 30 days?		Su'aasha 18	Waligaa shaqo makaqabatay meelkabaxsan gurigaaga taasoo aad mushaar kuhelayso 30 kii maalmood ee ugu danbeeyay?
SECTION E. HEALTH-SEEKING BEHAVIOR AND PROVIDER EXPERIENCE			QAYBTA E. HABDHAQANKA CAAFIMAAD RAADISKA IYO KHIBRADAHA AAD KALA KULANTAY ADEEG BIXIYAHA
		Now I am going to ask you some questions about your overall health and experiences with health care, services, and providers.			Hadda waxaan rabaa inaan wax kaawaydiiyo caadfimaadkaaga guud iyo khibradaha aad kala kulantay daryeelka caafimaadka, adeegyada, iyo adeeg bixiyaasha.
	Q19	In general, how would you describe your health? Is it excellent, very good, good, fair, or poor?		Su'aasha 19	Si guud, sidee ayaad kuqeexi lahayd caafimaadkaaga? Caafimaadkagu mataambaa, aad miyu ufiicanyahay, wuu roonyahay, dhexdhexaad, mise wuu liitaa?
		• Excellent • Very good • Good • Fair • Poor • Not sure • Prefer not to answer			• Waa taam • Aad buu ufiicanyahay • Waa ronyahay • Waa dhexdhexaad • Waa liitaa • Mahubo • Madoonaayo inaan kajawaabo
	Q20	How many times have you gone to a clinic or hospital for health care for yourself in the past 12 months?		Su'aasha 20	Meeqa jeer ayaad xarun caafimaad ama isbitaal aaday si daryeel caafimaad laguusiiyo 12 kii bilood ee lasoodhaafay?
		• Not at all • Once • Twice • 3-5 times • More than 5 times • Don’t Know • Prefer not to answer			• Marnaba ma aadin • Halmar • Labo jeer • 3-5 jeer • Wax kabadan 5 jeer • Ma aqaano • Madoonaayo inaan kajawaabo
	Q21	When visiting your doctor, would you like to have an interpreter present?		Su'aasha 21	Markaad booqanayso dhakhtarkaaga majeceshahay in turjumaan uu lajoogo?
		• Yes • No [GO TO Q24] • Do not have a doctor [GO TO Q24] • Don’t Know [GO TO Q24] • Prefer not to answer [GO TO Q24]			• Haa Maya [UGUDUB SU'AASHA 24] • Malihi dhakhtar [UGUDUB SU'AASHA 24] • Ma aqaano [UGUDUB SU'AASHA 24] Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 24]
	Q22	During your last visit, was an interpreter offered to you?		Su'aasha 22	Intii lagujiray booqashadaadii ugu danbaysay, turjumaan majoogay?
	Q23	Who usually serves as an interpreter for you?		Su'aasha 23	Qofkee ayaa intabadan wax kuufasira?
		• My health provider • Professional interpreter • A staff person • A friend or relative • My husband or other male relative • Other, please specify:			• Adeeg bixiyahay caafimaadka • Turjumaan xirfad uleh • Qof shaqaale ah • Saaxiib ama qof ehel ah • Ninkayga ama nin kale oo qaraabo aan nahay • Midkale, fadlan sheeg:
	Q24	Are you currently covered by any of the following types of health insurance?		Su'aasha 24	Waqti xaadirkaan caafimaadkaaga madaboolaa mid kamid ah noocyadaan soosocda ee caymiska caafimaadka?
		• A plan purchased through an employer or union (includes plans purchased through another person’s employer) • A plan that you or a family member buys on their own • Medicaid or other state or federal program • Some other source, please specify:			• Qorshe aad iibsatay adoo kaashanaaya qofka aad ushaqayso ama urur midow ah (ayna kujiraan qorshayasha lagu iibsaday shirkada u qofkale ushaqeeyo) • Qorshe caafimaad oo adigga am xubin kamid ah qoyskaagu iskiis u iibsaday • Medicaid ama barnaamij kale oo heer gobal ama federal ah • Ilo kale oo caymis, fadlan sheeg:
		• I do not currently have health insurance			• Waqti xadirkaan malihi wax caymis caafimaad ah
	Q25	During the past 12 months, was there any time when you needed medical care but didn't get it because you couldn't afford it?		Su'aasha 25	Intii lagu jiray 12 bilood ee lasoo dhaafay, majiray xili aad ubaahatay daryeel caafimaad laakiin aad wayday sabab laxariirta inaadan qarashkeeda iskabixin karin?
SECTION F. WOMEN’S HEALTH AND PREGNANCY OUTCOMES			QAYBTA F. NATIIJOOYINKA CAAFIMAADKA IYO UURKA EE HAWEENKA
		I am now going to ask you questions about family planning and your sexual health.			Hadda waxaan doonayaa inaan wax kaawaydiiyo qorshahaaga qoyska iyo caafimaadkaaga galmada.
	Q26	Have you ever used any contraceptives or birth control methods to avoid or delay getting pregnant?		Su'aasha 26	Waligaa ma isticmaashay daawooyinka uurka diida ama maadooyinka dhalmada lagu xakameeyo si aad uga fogaato ama aad udaahiso uurka aad yeelanayso?
	Q27	Which method(s) have you used? Have you ever used…? Have you used this method in the past 30 days?		Su'aasha 27	Qaababkee ayaad isticmaashay? Waligaa ma isticmaashay.....? Qaabkaan ma isticmaashay 30 maalmood ee lasoodhaafay?
		Ever Used?			Waligaa ma isticmaashay?
		Used in past 30 days?			Ma isticmaashay 30 maalmood ee ugu danbaysay?
		Female sterilization (tubes tied)			Minxirka haweenta (tubada minka oo laxiro)
		Male sterilization			Shahwo xirida ninka
		Contraceptive implant (Nexplanon, Jadelle, Sino, Implant, Implanon)			Qalabka jirka lagasho ee dhalmada joojiya (Nexplanon, Jadelle, Sino, Implant, Implanon)
		IUD (for example, Paragard, Mirena, Skyla, Liletta)			IUD (tusaale, Paragard, Mirena, Skyla, Liletta)
		Shots/Injections (for example, Depo-Provera)			Iskudirada/Cirbadaha (tusaale, Depo-Provera)
		Birth control pills (daily pills, any kind)			Kaniiniyada dhalmada joojiya (kaniiniyada maalinkasta laqaato, noocay noqdaanba)
		Contraceptive patch (Ortho Evra, Xulane)			Daawada lagaliyo ugxan mareenka (Ortho Evra, Xulane)
		Contraceptive ring (NuvaRing)			Badhanka dhalmada xiriga (NuvaRing)
		Male condoms			Cinjirka galmada ee ragga
		Diaphragm			Caloosha
		Female condoms			Cinjirka galmada ee dumarka
		Foam, jelly, or cream			Ubur, jeel, ama kareen
		Emergency contraception (morning after pill)			Daawada dhalmojoojinta xaalada degdega ah (subixii lacuno kaniiniga lacuno)
		Not having sex at certain times (rhythm or natural family planning)			Inaadan waqtiyo gaar ah galmo galin ((rhythm ama xakamaynta dhalmada ee dabiiciga ah)
		Withdrawal (pulling out)			Biyaha ninka oo banaanka loosaaro (ninka oo guska kalabaxa haweenka intuusan biyo bixin)
		Other, please specify:			Midkale, fadlan sheeg:
	Q28	In the past 12 months, have you had trouble getting the contraceptives or birth control methods you wanted for any reason?		Su'aasha 28	12 kii bilood ee lasoodhaafay, dhibaato makala kulantay noocyada daawooyinka aad dhalmada kuxakamaynayso sabab kastood urabtay?
		• Yes • No [GO TO Q30] • I did not need a birth control method [GO TO Q30] • Don’t Know [GO TO Q30] • Prefer not to answer [GO TO Q30]			• Haa Maya [UGUDUB SU'AASHA 30] • Uma baahan nooc dhalmo joojin ah [UGUDUB 30] • Ma aqaano [UGUDUB SU'AASHA 30] Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 30]
	Q29	Why did you have trouble getting the birth control method that you wanted?		Su'aasha 29	Maxaa sababay caqabada kaaqabsatay daawada dhalma xakamaynta ee aad doonaysay inaad isticmaasho?
	Q30	When was your last pelvic exam and/or pap smear?		Su'aasha 30	Goormay ahayd markii udanbaysay ee baaritaanka sinaha lagaa qaaday iyo/ama baaritaanka kaankarada xubinta taranka haweenta?
		• Within past year • 2-3 years ago • 3 to 5 years ago • More than 5 years ago • Never • Don’t Know • Prefer not to answer			• Intii lagu jiray sanadkii lasoo dhaafay • 2-3 sano kahor • 3 ilaa 5 sano kahor • Waxkabadan 5 sano kahor • Marna • Ma aqaano • Madoonaayo inaan kajawaabo
	Q31	How old were you when you had sexual intercourse for the first time? [READ IF NECESSARY: Do not count oral sex, anal sex, heavy petting, or other forms of sexual activity that do not involve vaginal penetration. Do not count sex with a female partner].		Su'aasha 31	Meeqo sano jir ayaad ahayd markii koobaad ee aad qof iskugalmootaan? [AKHRI HADDAY MUHIIM TAHAY: Hakudarin galmada afka, dabada, istiiminta, iyo noocyada kale ee galmada ee aan guska siilka lagalinayn. Hakudarin galmada dhexmara labada haween ah].
		• Under 18 years • 18-24 • 25-29 years • 30-39 years • 40-49 years • Over 49 years • Never had sexual intercourse [GO TO Q39] • Prefer not to answer			• Ka yar 18 sanno • 18 illaa 24 • 25-29 sano kahor • 30-39 sano kahor • 40-49 sano kahor • Ka badan 49 sanno • Marna qof uma galmoon [UGUDUB 40] • Madoonaayo inaan kajawaabo
SECTION G. WOMEN’S HEALTH AND PREGNANCY OUTCOMES			QAYBTA G. NATIIJOOYINKA CAAFIMAADKA IYO UURKA EE HAWEENKA
		To finish up our questions about health and health care, we have a few questions for you about pregnancy and prenatal care.			Si aan udhamaystirno su'aalaheena kusaabsan caafimaadka iyo daryeelka caafimaadka, waxaan rabnaa inaan dhawr su'aalood kaawayndiino uurka iyo daryeelka hooyada.
	Q32	Are you pregnant now?		Su'aasha 32	Uur maleedahay?
		• Yes • No [GO TO Q34] • Don’t Know [GO TO Q34] • Prefer not to answer [GO TO Q34]			• Haa Maya [UGUDUB SU'AASHA 34] • Ma aqaano [UGUDUB SU'AASHA 34] Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 34]
	Q33	Have you had prenatal care for this pregnancy?		Su'aasha 33	Daryeelka hooyada ma uheshay uurkaan?
		Now we have some questions about your children.			Hadda waxaan dhawr su'aalood kaawaydiinaynaa caruurtaada?
	Q34	How many children have you had that were born alive?		Su'aasha 34	Meeqa caruur ah ayaad dhashay oo nolol kudhashay?
		Now I will ask a few questions about each child you had beginning with the oldest one.			Hadda waxaan dhawr su'aalood kaawaydiinayaa cunug kasta ood dhashay laga bilaabo kan ugu wayn.
		Child			Canug
		1 2 3 4 5 6 7			1 2 3 4 5 6 7
	Q35	In what month and year was this child born?		Su'aasha 35	Bishee ama sanadkee ayuu cunugaan dhashay?
		Month: Year:			Bisha: Sanadka:
	Q36	Is this child still alive?		Su'aasha 36	Cunugaan wali manoolyahay?
		Yes No Prefer not to answer			Haa Maya Madoonaayo inaan kajawaabo
	Q37	Was this child born in the U.S.?		Su'aasha 37	Cunugaan ma wuxuu kudhashay Maraykanka?
		Yes No [GO TO 39] Prefer not to answer			Haa Maya [UGUDUB SU'AASHA 39] Madoonaayo inaan kajawaabo
	Q38	How many weeks (or months) pregnant were you at the time of your first prenatal care visit?		Su'aasha 38	Meeqa asbuuc (ama bilood) ayaad uurka lahayd markii koobaad ee tagto xarunta daryeelka hooyooyinka?
		Weeks Months No Prenatal Care Don’t Know Prefer not to answer			Abuuc Bilood Mahelin Daryeelka Hooyada Ma aqaano Madoonaayo inaan kajawaabo
	Q39	Was this baby delivered by caesarean section (c-section)?		Su'aasha 39	Ilmahaan malagugusoo qalay (qaybta C)
SECTION H. FGM/C			QAYBTA H. FGM (GUDNIINKA GABDHAHA)/C
intro		In a number of countries, there is a practice called circumcision in which a girl or young woman may have part of her genitals cut. Now I would like to ask you some questions about your knowledge and experiences with female circumcision.	isbarasho		Wadamo dhawr ah, waxaa kajira dhaqan layiraahdo gudniin kaasoo gabadha ama haweenayda da'yarta ah looga jaro qaar kamid ah xubnaheeda taranka. Hadda waxaan rabaa inaan wax kaawaydiiyo aqoonta aad uleedahay iyo khibradaha kaasoo maray gudniinka gabdhaha.
	Q40	Do you come from a family that has practiced the tradition of female circumcision?		Su'aasha 40	Mawaxaad kasoo jeedaa qoys kudhaqma caadada gudniinka gabdhaha?
	Q41	Does your husband come from a family that has practiced the tradition of female circumcision?		Su'aasha 41	Ninkaagu makasoo jeedaa qoys kudhaqma caadada gudniinka gabdhaha?
	Q42	Have you ever been circumcised?		Su'aasha 42	Waligaa malagu guday?
		• Yes • No [GO TO Q53] • Don’t Know [GO TO Q53] • Prefer not to answer [GO TO Q53]			• Haa Maya [UGUDUB SU'AASHA 53] • Ma aqaano [UGUDUB SU'AASHA 53] Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 53]
	Q43	What kind of circumcision do you have?		Su'aasha 43	Gudniin noocee ah ayaa lagu guday?
	Q44	How old were you when you were first circumcised?		Su'aasha 44	Meeqo sano jir ayaad ahayd markii koobaad ee lagu guday?
		• Less than 1 year old • 1-4 years old • 5-9 years old • 10-14 years old • 15-19 years old • More than 19 years old • Don’t Know • Prefer not to answer			• Ka yar 1 sanno jir • 1-4 sano kahor • 5-9 sano kahor • 10-14 sano kahor • 15-19 sano kahor • Wax kabadan 19 jeer • Ma aqaano • Madoonaayo inaan kajawaabo
	Q45	Now I would like to ask you some more questions about your circumcision. Was any flesh removed from the genital area?		Su'aasha 45	Hadda waxaan rabaa inaan dhawr su'aalood oo dheeri ah kaawaydiiyo gudniinkaaga. Majiraa jir lagaa jaray aaga taranka?
		• Yes [GO TO Q47] • No • Don’t Know • Prefer not to answer			• Haa [UGUDUB SU'AASHA 47] • Maya • Ma aqaano • Madoonaayo inaan kajawaabo
	Q46	Was the genital area nicked without removing any flesh?		Su'aasha 46	Aaga taranka miyaa lagaa tolay ayadoon cad lagaa jarin?
	Q47	Was your genital area sewn closed?		Su'aasha 47	Xubintaada taran tolmo miyaa lagu xiray?
	Q48	Have you ever had any health problems related to your circumcision?		Su'aasha 48	Waligaa makusoo wajahee wax dhibaatooyin caafimaad ah oo laxariira gudniinkaaga
		• Yes • No [GO TO Q50] • Don’t Know [GO TO Q50] • Prefer not to answer [GO TO Q50]			• Haa Maya [UGUDUB SU'AASHA 50] • Ma aqaano [UGUDUB SU'AASHA 50] Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 50]
	Q49	Please specify what health problems occurred.		Su'aasha 49	Fadlan sheeg nooca dhibaatooyinka caafimaad ee kugu dhacay.
	Q50	Would you feel comfortable discussing your circumcision with a health care provider?		Su'aasha 50	Makuqanacsantahay inaad kalahadasho arimaha gudniinkaaga dhakhtarka caafimaadka?
	Q51	Have you ever talked with a health care provider about your circumcision?		Su'aasha 51	Waligaa makala hadashay dhakhtarka wax kusaabsan gudniinkaaga?
		• Yes • No [GO TO Q53] • Don’t Know [GO TO Q53] • Prefer not to answer [GO TO Q53]			• Haa Maya [UGUDUB SU'AASHA 53] • Ma aqaano [UGUDUB SU'AASHA 53] Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 53]
	Q52	Who started the conversation about your circumcision, you or the health care provider?		Su'aasha 52	Yaa bilaabay kahadalka gudniinkaaga, adiga ama dhakhtarka?
		• You • Your health care provider • Don’t Know • Prefer not to answer			• Adiga • Daryeel bixiyahaaga caafimaadka • Ma aqaano • Madoonaayo inaan kajawaabo
		Have you ever experienced any of these health issues or conditions?			Waligaa makuqabsadeen mid kamid ah arimahaan caafimaad ama xaaladahaan?
	Q53	Have you ever had a/an. . .?		Su'aasha 53	Waligaa makuqabsaday xaalada..?
		Emergency C-section			Qaliinka Umulinta
		Postpartum hemorrhage			Dhiig baxa Dhalmada
		Extensive vaginal tears from childbirth			Dilaac wayn oo xubinta taranka ah sabab laxariirta dhalmada
		Pain with intercourse			Xanuun xiliga Galmada
		Bleeding with intercourse			Dhiigbax xiliga galmada
		Difficulty passing menstrual blood			Dhibaato kaaqabsata marinka dhiiga caadada
		Difficulty passing urine			Kaadida oo kugu dhagta
		Pain with urination			Kaadida oo kugu dhagta
		Recurrent Urinary Tract Infections			Infakshanada kaadi Mareenka oo soo Noqnoqda
		Feeling sad for many weeks at a time			Murug kuqabsata asbuucyo badan
		yes			haa
	Q54	[if YES] Did you seek professional health care for this?		Su'aasha 54	[Hadday tahay HAA) Xanuunadaan dhakhtar cafimaad oo khibrad uleh ma ulatagtay?
		Yes No Not treatable by a doctor			Haa Maya Dhakhtar madaawayn karo
	Q55	[if YES] Were you satisfied with how the problem was addressed?		Su'aasha 55	[Haday tahay HAA] Makuqanacday sida xanuunkaaga loo maareeyay?
	Q56	Is this an ongoing problem?		Su'aasha 56	Tani ma dhibaato joogto ah baa?
		<REFER TO RESOURCE HANDOUT TO RESPONDENT FOR COUNSELING AND SUPPORT GROUPS>			<USHEEG QOFKA AAD WARAYSANAYSID BUUGA MACLUUMAADKA MEESHA UU TALOBIXINTA IYO KOOXA TAAGEERADA BIXIYA KAHELAAYO>
SECTION I. FGC BELIEFS			QAYBTA I. FIKRADAHA KU AADAN GUDNIINKA FURCOONIGA AH EE GABDHAHA (FGM)
		I am now going to ask you some questions about your beliefs and opinions about female circumcision.			Hadda waxaan rabaa inaan dhawr su'alood kaawaydiiyo fikradaha iyo waxyaabaha aad ka aaminsatahay gudniinka gabdhaha.
	Q57	In your opinion, can female circumcision cause any health problems for women later on (for example during pregnancy and delivery)?		Su'aasha 57	Fikirkaaga ahaan, gudniinka gabdhuhu makeenaa wax dhibaatooyin caafimaad oo kudhaca haweenka mustaqbalka danbe (tusaale markay uurka leeyihiin iyo markay dhalayaan)?
	Q58	What are your husband’s views about female circumcision? Do you think he would say. . .		Su'aasha 58	Ninkaagu fikrado noocee ah ayuu kaqabaa gudniinka gabdhaha? Ma umalaynaysaa inuu oron lahaa. . .
		¨ It should be stopped			¨ Waa in lajoojiyaa
		¨ It should continue as is			¨ Waa in siday tahay loosii wadaa
		¨ Depends on the family			¨ Waxay kuxirantahay qoyska
		¨ I have mixed feelings about it			¨ Waxaan kaqabaa fikrado kaladuwan
		¨ Other, please specify:			¨ Midkale, fadlan sheeg:
	Q59	Which of the following best describes your views about female circumcision? Would you say…		Su'aasha 59	Midkee kamid ah qodobada soosocda ayaa sifiican uqeexaaya fikirka aad kaqabto gudniinka gabdhaha? Waxaan oroan lahaa...
	Q60	Do you believe that female circumcision is required by your religion?		Su'aasha 60	Ma aaminsantahay in guurka gabdhaha ay tahay arin diiniyan loobaahanyahay?
		• Yes • No • No Religion • Don’t Know • Prefer not to answer			• Haa • Maya • Diin Ma aaminsani • Ma aqaano • Madoonaayo inaan kajawaabo
	Q61	Has your opinion about female circumcision changed in any way since you moved to the U.S.?		Su'aasha 61	Fikirka aad kaqabto gudniinka gabadhuhu ma isbadalay sinaba ilaa intaad Maraykanka usoo guurtay?
		• Yes • No [GO TO Q63] • Not applicable, did not have opinion before moving to U.S. [GO TO Q63] • Don’t Know [GO TO Q63] • Prefer not to answer [GO TO Q63]			• Haa Maya [UGUDUB SU'AASHA 63] • Ima qusayso, wax fikir ah kama qabin kahor intaanan Maraykanka usoo guurin (UGDUB SU'AASHA 63) • Ma aqaano [UGUDUB SU'AASHA 63] Madoonaayo inaan kajawaabo [UGUDUB SU'AASHA 63]
	Q62	How has your opinion changed?		Su'aasha 62	Maxaa iskabadalayy fikirkaaga?
		Probe: Would you say your opinion is: • More accepting of female circumcision • Less accepting of female circumcision • Don’t Know • Prefer not to answer			Baaritaan: Ma oran lahayd in fikirkaagu: • Uu aad uwaafaqsanyahay gudniinka gabdhaha • Uusan inbadan waafaqsanayn gudniinka gabdhaha • Ma aqaano • Madoonaayo inaan kajawaabo
SECTION J. EDUCATION			QAYBTA J. WAXBARASHADA
	Q63	What is the highest level of schooling you have completed?		Su'aasha 63	Waa maxay heerka ugu sareeya ee aad waxbarashada lagaartay?
		• No formal school • Less than a high school diploma • High school diploma or GED • Some college credit, no degree • Associate’s degree (for example: AA, AS) • Bachelor’s degree or higher (for example: BA, BS, MA, MS, MD, PhD, etc) • Don’t Know • Prefer not to answer			• Ma akhrisan dugsi caadi ah • Wax kahooseeya shahaadada dugsiga sare • Shahaadada dugsiga sare ama GED • Heer kuleej, magaarin shahaadada degreega • Shahaadada heerka koobaad (tusaale: AA, AS) • Shahaadada jaamacada ama kasi kor (tusaale: BA, BS, MA, MS, MD, PhD, iwm) • Ma aqaano • Madoonaayo inaan kajawaabo
	Q64	Have you ever attended school in the U.S.?		Su'aasha 64	Waligaa dugsi Maraykanka kuyaala madhigatay?
		• Yes • No [END OF SURVEY] • Prefer not to answer			• Haa • Maya[DHAMAADKA SAHANKA] • Madoonaayo inaan kajawaabo
	Q65	Are you attending school now?		Su'aasha 65	Hadda dugsi madhigataa?
STUDY INVITE CARD			KAARKA CASUMAADKA DARAASADA
		Congratulations! The person who gave you this card thinks you would be a good fit for our study.			Hambalyo! Qofkii kusiiyay kaarkaan wuxuu aaminsanyahay inaad kuhaboontahay daraasadeena.
		INTERESTED IN BEING PART OF THE WOMEN’S HEALTH NEEDS STUDY? • Please contact (NAME) for more information.			MADOONAYSAA INAAD KAQAYBGASHO DARAASADA BAAHIYAHA CAAFIMAADKA HAWEENKA? • Fadlan laxariir MAGACA) si aad macluumaad dheeri ah uhesho.
		Call: or email: WomensHealthNeeds@norc.org			Wac: ama email udir: WomensHealthNeeds@norc.org
INFORMED CONSENT			OGOLAANSHAHA LA OGEEYSIIYAY
Women’s Health Needs Study Informed Consent to be a Research Participant			Ogolaansho faahfaahsan oo laxariira kaqaybgalka cilmi baarista
		My name is _______________and I am working with NORC and the Centers for Disease Control and Prevention on this study.			Magacaygu waa _______________waxaan lashaqaynayaa haayada NORC iyo Xarumaha Xakamaynta iyo Kahortaga Xanuunada oo ayagu daraasadaan samaynaaya.
		Why we are doing this study? We are trying to find out about the health care needs of women age 18 to 49 years in your community. We plan on interviewing about 100 women for this study.			Maxaan usamaynaynaa daraasadaan? Waxaan rabnaa inaan wax ka ogaano baahiyaha caafimaadka ee haweenka da'doodu udhaxayso 18 ilaa 49 ee mujtamaca kamid ah. Waxaan qorshaysanay inaan 100 haween ah kuwaraysano daraasadaan.
		Who is funding this study? This study is funded by the Centers for Disease Control and Prevention.			Yaa maalgalinaaya daraasadaan? Daraasadaan waxaa maalgalinaaya Xarumaha Kahortaga iyo Xakamaynta Cududrada.
		What would I be asked to do if I am in this study?			Maxaa layga doonayaan inaan sameeyo haddaan daraasadan kaqaybgalo?
		The interview will take you about 45 minutes.			Waraysiga ayaa kugu qaadanaaya kudhawaad 45 in lagu dhamaystiro.
		We will read you the questions in your preferred language.			Waxaan su'aalaha ku akhrinaysaa luuqada aad jeceshahay.
		We will be asking you some questions to see if you are eligible to be in the study.			Waxaan ku weydiin doonaa su'aalo dhowr ah si aan u aragno haddii aad u qalantid in aad daraasadda ku jirto.
		These will be about things like where you and your family are from, what languages you speak, and if you have lived in certain countries.			Kuwani waxay noqon doonaan wax ku saabsan waxyaabaha sida halka adiga iyo qoyskaaga aad ka imaateen, luuqadaha aad ku hadasho, iyo haddii aad ku noolaatay dalal gaar ah.
		If you are eligible, give consent, and then choose to enroll in the study, then we will be asking you questions such as how long you have been in the US, if you have had a medical exam, your childbirth experiences, and what you and your family thinks about female circumcision and your experiences with female circumcision.			Waxaan wax kaawaydiinayaa waxyaabaha sida meeshaad katimid, mudada aad Maraykanka joogtay, inaad baaritaan caafimaad martay iyo inkale, fikradaha qoyskaagu kaqabaan gudniinka gabdhaha, khibradahaaga dhanka dhalmada, iyo fikirkaaga shaqsiga ah ee ku aadan gudniinka gabdhaha.
		Some of the study questions may make you feel uncomfortable. You can skip any question. Your answers are completely private and only results from the whole group of women will be included in any report.			Qaar kamid ah su'aalaha daraasadaan ayaa laga yaabaa inaadan kuqancin. Waad kaboodai kartaa su'aashaad rabto. Jawaabaha aad bixiso waa kuwo si buuxda gaar kuugu ah kaliyana natiijooyinka lagasoo qaado dhamaan haweenka lawaraysto ayaa lagu darayaa wixii warbixin ah.
		How long will it take for me to participate in this study? For this study you will do one interview that will take about 45 minutes to complete. This will end your time in the study.			Muddo intee le'eg ayay igu qaadan doontaa inaan ka qayb qaato daraasaddan? Daraasaddani dhexdeeda, waxaad sameyn doontaa hal wareysi oo kugu qaadan doona qiyaas ahaan 45 daqiiqo inaad dhamaystirto. Tani waxay dhameeyn doontaa waqtigaaga daraasadda.
		Are there any risks for me if I decide to participate? The risks to participating in this research are minimal. However, some of the questions are personal and might make you uncomfortable. You are free to skip or not answer any questions. You can stop at any time. I have community resources available for you if you need help finding support or services in your community.			Ma jiraan wax halis ii ah haddii aan go'aansado in aan ka qayb qaato? Halista ka qayb qaadashada cilmi-baaristan ​​waa mid aad u yar. Si kastaba ha ahaatee, qaar ka mid ah su'aaluhu waa gaar oo waxaa laga yaabaa inaad dhibsato. Waxaad xor u tahay inaad ka boodid ama aadan ka jawaabin wax su'aalo ah. Waad joojin kartaa wakhti kasta. Waxaan haystaa ilaha bulshada oo aad heli karto haddii aad ubaahato caawimaad ah sidii aad u heli lahayd taageero ama adeegyada bulshada.
		If you choose to do the survey whether you complete the survey or not, you will not lose access to any services that you would otherwise be eligible for. Your answers will be kept private to the extent allowed by law and will be used only for research. The study has a Certificate of Confidentiality, so no one outside the study, even an official of the court, the government or law, can request your information. However, if interviewers and other study staff learn of plans to have your minor daughter circumcised they may be legally obligated to report this as child abuse to state or local authorities The study does not ask you about circumcision in your daughter.			Haddii aad dooratid inaad samayso sahankan oo aad dhamaystirtid ama aadan dhamaystirin sahanka, ma waayi doontid helitaanka adeegya kasta oo aad u qalantid. Jawaabahaaga waxaa loo hayn doonaa si gaar ah illaa xadka uu sharcigu ogol yahay waxaana loo isticmaali doonaa ilmi-baarista oo kaliya. Daraasada waxay leedahay Shahaadada Qarsoonida, sidaas darteed qof ka baxsan daraasada ma codsani kara macluumaadkaaga, xitaa ha noqdo sarkaal maxkamad, dowlada ama sharciga. Si kastaba ha ahaatee, haddii wareystayaasha iyo shaqaalaha kale ee daraasadda ay ogaadaan qorshooyin ah in gabadhaada yar la gudo, waxaa laga yaabaa inay sharci ahaan waajib ku tahay in ay uga war bixiyaan dawladda ama maamulka degaanka xadgudubka caruurta ahaan. Daraasadda kuma waydiso wax ku saabsan gudniinka gabadhaada.
		Employees of CDC, or experts and contractors working for CDC, may review information sent through computer networks to assess security. We will not collect your name or other information that identifies you during this interview. When results from this research are presented, we will not include any information that might be used to figure out who you are.			Shaqaalaha CDC, ama khabiirada iyo qandaraasleyda u shaqeynaya CDC, waxay dib u eegi karaan macluumaadka lagu diro shabakadaha kombiyuutarada si ay u qiimeeyaan amniga. Ma aruurin doonno magacaaga ama macluumaadkaaga kale ee aqoonsiga inta lagu jiro waraysigan. Marka natiijooyinka ka soo baxa cilmi-baaristaan ​​la soo bandhigayo, kuma dari doono wax macluumaad ah oo loo isticmaali karo in lagu ogaado qofka aad tahay.
		Are there any benefits for me if I decide to participate? There is no direct benefit to you for participating in the study. We believe the answers you provide will help us better understand the health care needs of women in your community.			Ma jiraan wax faa'iido ii ah haddii aan go'aansado in aan ka qayb qaato? Ma jirto faa'iido toos ah oo aad ka heleeysa ka qayb qaadashada daraasadda. Waxaan aaminsan nahay in jawaabaha aad bixiso ay naga caawinayaan inaan si fiican u fahanno baahiyaha daryeelka caafimaadka ee haweenka bulshadaada.
		Payment for participation: If you agree to be in this study we will give you $20 for your travel and/or child care expenses. In addition, if you recruit another women to be in this study, we will give you $5 for cell phone calls and/or transportation. You may recruit up to 3 women and receive $5 for each woman you recruit. You may need to contact these 3 women with our study invitation card. You will be able to receive a total of $35 reimbursement for expenses you may need to participate in the study and for recruiting up to three women.			Bixinta qarashka kaqaybgalka: Hadaad ogolaato inaad waraysiga kaqaybgasho waxaan kusiinaynaa $20 si aad isga dabarto safarkaaga iyo/ama daryeelka ilmaha. Intaa waxaa dheer, haddii aad qorto haween kale oo ka qayb qaadanaysa daraasaddan, waxaan ku siin doonaa $5 oo loogu talagalay wicitaannada teleefoonka iyo/ama jid marka. Waxaad qori kartaa ilaa 3 haween ah waxaadna heli $5 haweenay kasta oo aad qorato. Intaas waxaa siidheer, hadaad awodo inaad waraysiga soogaliso 3 haween ah oo dheeri ah si ay daraasada uga qaybagalaan, waxaan kusinaynaa $5 midkiiba si aad ugu dabarto wicitaanka taleefanka iyo/ama qarashka gaadiidka si aad 3 haweenka ah ugaarsiiso kaarkeena casuumaada. Waxaad awoodi doontaa inaad hesho lacag dhan $35 si aad ugu dabarto qarashadka aad ugu baahantahay kaqaybgalka daraasada iyo 3 haween ah ee aad awoodo inaad daraasada kusoo darto.
		A unique passcode will let us know which women you helped recruit so that we can reimburse you. Your name will not be collected at any time during this study.			Fura gaar ah ayaa noo sheegi doona haweenka aad caawisay qoristooda si aan kuu siino lacagta. Magacaaga lamasoo qoraay marna inta daraasadaan socoto kaqaybgalkaaguna wax lacag ah kaama cunaayo.
		Do I have to be in this study? No you do not. If you choose to be in this study, you can stop at any time and you are also free to skip or not answer any questions.			Ma inaan ku jiraa daraasaddan? Maya, maha inaad ku jirto. Haddii aad doorato inaad ku jirto daraasaddan, waxaad joojin kartaa wakhti kasta waxaadna xor u tahay inaad ka boodid ama aadan ka jawaabin wax su'aalo ah.
		What happens if I would like to stop this interview? If you start the interview and decide to stop, that is perfectly OK. You will still receive the $20 for your travel and/or any child care expenses you may have during this interview.			Maxaa dhacaya haddii aan jeclaado inaan joojiyo waraysigan? Haddii aad bilowdo wareysiga oo hadana aad go'aansato in aad joojiso, taasi waa wax caadi ah. Waxaad weli helaysaa $20 ee safarkaaga iyo/ama qarashka xanaanada ilmahaagu ee laga yaabo inaad gesho inta lagu jiro waraysiga.
		We will be able to keep and use the information you have shared up until that point. If you do not want your responses to be included, let us know and we will destroy your information.			Waxaan awoodi doonaa inaan hayno oo aan isticmaalno macluumaadka aad wadaagtay inta aad joojin ka hor. Haddii aadan rabin in jawaabahaaga lagu daro, nala soo socodsii waana baabiin doonaa macluumaadkaaga.
		Right to Ask Questions: Please contact Field Coordinator at (XX) with questions, complaints or concerns about this research. If you have any questions or concerns about your rights as a research participant, please contact the NORC IRB Manager by toll-free phone number at (866) 309-0542. An Institutional Review Board (IRB) operates under Federal regulations and they review research involving human subjects to ensure the ethical, safe, and equitable treatment of study participants.			Xuquuqda Su'aalo Weydiinta: Fadlan kala xiriir Iskuduwaha Goobta (XX) wixii su'aala, cabashooyin ama walaaca ku saabsan cilmi-baaristan ah. Haddii aad qabto wax su'aalo ah ama walaac ah oo ku saabsan xuquuqdaada ka qayb qaataha cilmi-baarista ahaanta ah, fadlan kala xiriir Maamulaha NORC IRB lambarka bilaashka ah (866) 309-0542 Guddiga Dib U-eegista Hay'adaha (IRB) wuxuu ku shaqeeyaa sharciyada Federaalka ah waxayna dib u eegaan cilmi-baarista ku saabsan maadooyinka ah aadanaha si loo hubiyo wanaajinta anshaxa, nabadgelyada, iyo hab-nololeedka ka qayb qaatayaasha daraasada.
		Do you have any questions about this study? If you have any questions or concerns regarding this study please ask. If you think of them later, contact the study number at 866-315-7130.			Miyaad qabtaa su'aalo ku saabsan daraasaddan? Haddii aad qabtid wax su'aalo ama walaac ah oo ku saabsan daraasaddan fadlan weydii. Haddii aad dib uga fikirtid, la xiriir lambarka daraasadda 866-315-7130.
		What if I do not want to be in this study? If you do not wish to participate, we sincerely thank you for your time.			Maxaa dhacaya haddii aanan rabin in aan ku jiro daraasaddan? Haddii aadan jeclayn inaad ka qayb qaadato, waxaan si daacad ah kuugu mahad celineynaa wakhtigaaga.
		If you would like to participate: You must be 18 to 49 years of age to take part in this research study.			Haddii aad jeclaan lahayd inaad ka qeyb qaadato: Waa inaad tahay 18 ilaa 49 sanno jir si aad uga qayb qaadato daraasaddan cilmi-baarista.
		Participation in this study implies that you have reviewed and understand what is being asked of you for this study and that you are voluntarily willing to take part of this study. Your answers will be private and you can stop at any time.			Ka qayb qaadashada daraasaddan waxay muujinaysaa inaad dib u eegtay oo aad fahantay waxa lagu waydinayo daraasaddan dhexdeeda iyo in aad si ikhtiyaari ah u doonayso inaad ka qayb qaadato daraasaddan. Jawaabahaagu waxay noqon doonaan kuwa gaar ah, waadna joojin kartaa wakhti kasta.
		Would you like a copy of this form?			Ma jeclaan lahayd nuqulka foomkan?