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At the Center is a FREE quarterly "webzine" designed to help those who are involved in the daily operation of CPCs. By returning this form, those of you in the USA will be notified by mail when each new issue is posted to this site.

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Name of Organization

Contact Person

Street Address

City, State, and Zip Code

Phone Number

E-Mail Address(es)







Is your center presently operating as a licensed medical clinic?
yes   no

We are members of (check all that apply)...
Partners in Ministry
Birthright
CareNet
Heartbeat
NIFLA
Sav-A-Life
WELS
Not affiliated with any group
Other:

During an average month, how many...

Clients do you see?
n/a   1-25   26-50   51-75   76-100   over 100

Pregnancy Tests do you use?
n/a   1-25   26-50   51-75   76-100   over 100

Pregnancy Tests are Positive?
n/a   1-5   6-10   11-15   16-20   over 20

Abortion-minded clients come in?
n/a   1-25   26-50   51-75   76-100   over 100

Spiritual decisions are made?
n/a   1-25   26-50   51-75   76-100   over 100

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