1.What is your age?

12 to 17

18 to 30

31 to 40

41 to 50

51 and over

2.How safe would you rate your community

Extremely safe

Very safe

Somewhat safe

Not so safe

Not at all safe

3.Please Identify any of the below concerns for youth in your community

Overdoses

Alcohol 

Prescription Drugs 

Opioids 

Tobacco Products

Marijuana 

None of the above

4.My community needs more resources for youth and their families

yes

no

I don't know

5.What community resources would you like to see in your community

6.What is your zipcode