This survey is sponsored by Durham Middlefield Local Wellness Coalition (DMLWC), a coalition that mobilizes youth, parents and community partners to prevent substance misuse, promote behavioral and mental health and strengthen healthy choices through positive youth, family and community development.
The information we gather with this survey will allow DMLWC to better serve our youth and families with local prevention programming.
You are urged to answer honestly. THE SURVEY IS COMPLETELY ANONYMOUS AND NO ONE WILL
KNOW WHAT YOU SAY.

Question Title

* 1. What is your town of residence?

Question Title

* 2. Your gender:

Question Title

* 3. Your age:

Question Title

* 4. Had you heard about DMLWC prior to receiving this survey?

Question Title

* 5. How familiar are you with…

  Unfamiliar Somewhat familiar Very familiar
the initiatives that DMLWC provides in the communities (training programs, youth survey, Drug Take Back Day, family activities, etc.)?
the Connecticut law raising the legal age to purchase tobacco and vaping products to age 21?
the state’s Social Host Law that makes it illegal to provide a place for teens to drink?
the Connecticut law legalizing retail cannabis (marijuana, THC, weed, edibles) use for adults 21 years or older?
the proper ways to dispose of unused, unneeded or excess prescription drug medications that are in your home?

Question Title

* 6. In the past year, have you disposed of unused or expired medications in any of the following methods:  (check all that apply)

Question Title

* 7. When considering Durham Middlefield youth and young adults how concerned are you with…

  Not at all concerned A little bit concerned Somewhat concerned Very concerned
Mental health issues (including anxiety and stress)
Use of alcohol
Use of marijuana
Use of illicit drugs (such as heroin, cocaine)
Abuse of prescription medications (including pain medications, tranquilizers, and stimulants)
Vaping (e-cigs, JUULs)
Use of tobacco or cigarettes
 
 25% of survey complete.
Share

T