What is your gender?

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* 1. What is your gender?

What grade level did you begin in September of 2017?

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* 2. What grade level did you begin in September of 2017?

Are there questions about drugs and/or alcohol you would like to ask your parents or teachers but have been too afraid or embarrassed to ask?

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* 3. Are there questions about drugs and/or alcohol you would like to ask your parents or teachers but have been too afraid or embarrassed to ask?

Do you have a friend or do you know someone about your age that you are worried may have a problem with drugs or alcohol?

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* 4. Do you have a friend or do you know someone about your age that you are worried may have a problem with drugs or alcohol?

If you had a friend with a drug or alcohol problem who would you ask for help? Choose an answer for each option.

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* 5. If you had a friend with a drug or alcohol problem who would you ask for help? Choose an answer for each option.

  Yes No Maybe
Your parents
My friend's parents
School Guidance Counselor
School Nurse
School Resource Officer
Principal
Teacher
Coach
Religious leader
Doctor
Try to get them to ER
Google for information to help
Say you told your friend you were worried  about them and that you had a way to get help for their drug or alcohol problem, but they said no.

Why do you think they would refuse help? Because they...
(Check the ones you think could be true)

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* 6. Say you told your friend you were worried  about them and that you had a way to get help for their drug or alcohol problem, but they said no.

Why do you think they would refuse help? Because they...
(Check the ones you think could be true)

Do you have a friend or know someone who might be seriously depressed , anxious or at risk for suicide?

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* 7. Do you have a friend or know someone who might be seriously depressed , anxious or at risk for suicide?

Would you know how to get help for a friend who was suffering from depression, anxiety or was having suicidal thoughts?

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* 8. Would you know how to get help for a friend who was suffering from depression, anxiety or was having suicidal thoughts?

Would you ask for help for a friend suffering from depression or anxiety from any of these people? Choose an answer for each option.

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* 9. Would you ask for help for a friend suffering from depression or anxiety from any of these people? Choose an answer for each option.

  Yes No Maybe
Your parents
My friend's parents
School Guidance Counselor
School Nurse
School Resource Officer
Principal
Teacher
Coach
Religious leader
Doctor
Try to get them to ER
Google for information to help
If a friend who was suffering from depression or anxiety told you they do not want any help. Why do you think they would say this?

(Check all you believe may be true.)

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* 10. If a friend who was suffering from depression or anxiety told you they do not want any help. Why do you think they would say this?

(Check all you believe may be true.)

Have you thought about what you would like to do when you graduate from High school?

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* 11. Have you thought about what you would like to do when you graduate from High school?

Have you discussed these ideas or plans with anyone at the high school? 

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* 12. Have you discussed these ideas or plans with anyone at the high school? 

Have you done anything proactive to explore your ideas about after you finish high school, such as research, job search, or looking at colleges?

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* 13. Have you done anything proactive to explore your ideas about after you finish high school, such as research, job search, or looking at colleges?

Which type of cell/mobile phone do you have?

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* 14. Which type of cell/mobile phone do you have?

Who pays your monthly phone bill?

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* 15. Who pays your monthly phone bill?

Which types of Social Media and Apps do you use, and how often?


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* 16. Which types of Social Media and Apps do you use, and how often?


  Yes, daily Yes, occasionally Rarely Never
Facebook
Twitter
Snapchat
Instagram
My Space
YouTube
Live.ly
Houseparty

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