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CSUP Sticker Shock Survey
Thank you for wanting a Safe Storage bag!
*
1.
Do you currently use a safe storage system for your medications or cannabis?
(Required.)
Yes
No
Other (please specify)
2.
Do you live with any children or youth from birth to age 21?
Yes
No
Other (please specify)
3.
What will you store in this bag?
Prescribed Medication
Over the counter medication
Cannabis
Vapes
Tobacco
Other (please specify)
*
4.
What city in Kandiyohi do you live in?
(Required.)
Willmar
New London
Spicer
Atwater
Raymond
Kandiyohi
Prinsburg
Pennock
Lake Lillian
Blomkest
Sunburg
Regal
Type in your address here
