Survey Information

Thank you for participating in this survey! We are asking individuals between the ages of 18-25 years to share their opinions about alcohol, prescription drug misuse and heroin use. This survey is completely anonymous, and will be used to help inform prevention efforts in your community.

Important Information for Respondents

• This survey is completely anonymous and does not record any personal identifying information. Please answer all questions truthfully.

• The survey is completely voluntary. You may choose not to participate at any time. In order to complete the survey, you must answer questions #1 & #2 to confirm whether you have taken this previously and which age group you are in. After these two questions, you may skip any questions you are not comfortable answering.

• The information from the survey will be released in summary form only. No individual responses will be shared.

• At the end of the survey you will be able to enter a drawing for one of the following 25 gift cards: $10 Target Gift Card (10); $10 Kroger Gift Card (10); $10 Chick-fil-A Gift Card (5). Your contact information for the drawing will be collected in a separate location and can never be linked to your survey responses. You may only enter the drawing once; duplicate entries will be discarded.

If you have any questions or concerns about the survey, please contact OMNI Institute Support at: or 303.839.9422. OMNI Institute is an organization working with coalitions across the state of Virginia to learn more about substance use among young adults.

Clicking the “Next” button below indicates that:
• You have read and understand the above information
• You voluntarily agree to participate
• You are between the ages of 18 and 25 years-old
• You are a Virginia resident