Few research studies compare results from self-administered bilingual paper questionnaires on how the positioning of skip instructions may affect the respondent’s ability to follow skip patterns. Using data from the 2004 and 2005 of the Phase 5 Pregnancy Risk Assessment Monitoring System (PRAMS) mail survey questionnaire, this paper attempts to fill this gap. We examined whether the positioning of skip instructions can produce differences in item nonresponse rates in subsequent items and how results compare between English and Spanish language questionnaires. These results will be of interest to designers of bilingual self-administered survey questionnaires in guiding respondents through the intended navigational path with skip patterns.