<h3>Background</h3> Universal gonorrhea and chlamydia (GC/CT) screening (offering GC/CT testing regardless of self-reported sexual activity) is a potentially effective method to address limitations of risk-based screening. No published studies have evaluated adolescents' perspectives on universal GC/CT screening in a primary care setting. The purpose of this study is to describe previous GC/CT testing experiences among adolescents, and their intention to accept universal testing. <h3>Methods</h3> We conducted a cross-sectional quantitative survey study using convenience sampling at 2 academic center-affiliated primary care clinics in North Carolina. Eligible participants were English-speaking adolescents (13-23 years-old) seen within the past 3 years. Recruitment was via telephone. Variables of interest included age, sex, gender, sexual orientation, sexual behavior/activity, race, and factors related to acceptance of universal screening. History of GC/CT testing was examined in relation to variables of interest. The primary outcome was intention to be tested for GC/CT by universal screening in the future. Descriptive and bivariable statistics were calculated using χ2 and logistic regression. <h3>Results</h3> 68 adolescents have completed the survey and were included in this analysis. The majority of respondents self-identified as non-White (80%), heterosexual (77%), and female gender (59%). The mean age was 16.6 (range 13-21). 47% of the sample reported being sexually active, but only 40% had ever been tested for GC/CT. Sexual activity was not associated with a history of being tested (p=0.285). Of those tested in the past year (71%), most cited "because a healthcare provider recommended testing" as reason for testing (62%). The most common enabler for testing was physician recommendation (72%), and the most common barrier was not being sexually active (45%). The majority of respondents intend to be screened (81%). Those who do not intend to be screened (19%) were younger (mean 15.6 vs 16.8 years old, p=0.070), had never been tested for GC/CT (100%, p=0.003), and reported no sexual activity (92%, p=0.002). Of respondents who do not intend to be screened, 77% chose not being sexually active as a reason to not be comfortable testing. All respondents who identified as nonbinary gender or non-heterosexual reported intention to be screened. <h3>Conclusions</h3> Our findings suggest that many adolescents who are sexually active are not being screened for GC/CT. However, the majority of adolescents intend to be universally in the future. We found physician recommendation it is a key factor for adolescents agreeing to screening. Providers should foster open communication with adolescents about their personal risks and well-being.