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Assist Survey
1.
What is your age range?
18 or under
19-24
25-39
40-59
60+
2.
What is your zip code?
3.
What is your gender?
Male
Female
Nonbinary
Prefer not to disclose
4.
On a scale of 1-5, how safe do you feel in your community? (1=very unsafe and 5=very safe)
1
2
3
4
5
5.
Which safety concerns are most important to you? (Select all that apply)
Gun violence
Theft
Drug-related crime
Bullying
Domestic violence
Traffic safety
Other
6.
Has concern about violence changed how you live your daily life?
Yes
No
Unsure
7.
How informed do you feel about ways to prevent gun violence?
Very informed
Somewhat informed
Not very informed
Not at all informed
8.
Have you ever received education on safe firearm storage?
Yes
No
9.
Where do you typically get information about community safety? (Select all that apply)
School
Social Media
News
Family/Friends
Community Organizations
Law enforcement
Other
10.
Do you believe safe firearm storage can help prevent accidental injuries and theft?
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree