ADULT: Lock It Up Survey

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* 1. Do you have unused or expired medications at home?

Yes

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* 2. How do you store your medicines:

Locked

Unlocked

Depends on the medication - some are locked and some are unlocked

N/A, no medicines present

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* 3. How would you dispose of expired medicines or those you no longer need?

Flush them down the toilet

Discard them in the garbage or recycling

Mix them with an undesirable substance (i.e. kitty litter, coffee ground)s and discard

Return them to a pharmacy that will accept them

Take them to my medical office or clinic

Take them to a National Drug Take Back Day location

Take them to a household hazardous waste facility

Take them to a law enforcement agency that will take them

Never get rid of old medicines

I never have old medications because I use them all

Other (please specify)

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* 4. On a scale of 1 – 10, how easy (1) or difficult (10) would it be to access medications from your home?

1 (VERY easy)

3 (somewhat easy)

5 (moderate)

8 (hard)

10 (VERY hard)

N/A

1 (VERY easy)

3 (somewhat easy)

5 (moderate)

8 (hard)

10 (VERY hard)

N/A

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* 5. Do you have cannabis/ marijuana (medical or otherwise) at home?

Yes

No If no, skip to Question 8.

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* 6. How do you store cannabis/ marijuana? Skip this question if you answered NO to question 5.

Locked

Unlocked

N/A, no cannabis present

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* 7. On a scale of 1 – 10, how easy (1) or difficult (10) would it be to access cannabis/ marijuana from your home? Skip this question if you answered NO to question 5.

1 (VERY easy)

3 (somewhat easy)

5 (moderate)

8 (hard)

10 (VERY hard)

N/A

1 (VERY easy)

3 (somewhat easy)

5 (moderate)

8 (hard)

10 (VERY hard)

N/A

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* 8. Do you have alcohol at home?

Yes

No If NO, skip to question 11.

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* 9. How do you store your alcohol? Skip this question if you answered No to question 8.

Locked

Unlocked

N/A, NO ALCOHOL PRESENT

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* 10. On a scale of 1 – 10, how easy (1) or difficult (10) would it be to access alcohol from your home? Skip this question if you answered No to question 8.

1 (VERY easy)

3 (easy)

5 (moderate)

8 (hard)

10 (VERY hard)

N/A

1 (VERY easy)

3 (easy)

5 (moderate)

8 (hard)

10 (VERY hard)

N/A

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* 11. Are you aware of the Social Host Ordinance in your community (City of Santa Cruz, Santa Cruz County, Scotts Valley & Watsonville) which allows law enforcement to hold the host accountable for a gathering where alcohol is served to or consumed by minors?

Yes

ADULT: Lock It Up Survey

Question Title

* 1. Do you have unused or expired medications at home?

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* 2. How do you store your medicines:

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* 3. How would you dispose of expired medicines or those you no longer need?

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* 4. On a scale of 1 – 10, how easy (1) or difficult (10) would it be to access medications from your home?

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* 5. Do you have cannabis/ marijuana (medical or otherwise) at home?

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* 6. How do you store cannabis/ marijuana? Skip this question if you answered NO to question 5.

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* 7. On a scale of 1 – 10, how easy (1) or difficult (10) would it be to access cannabis/ marijuana from your home? Skip this question if you answered NO to question 5.

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* 8. Do you have alcohol at home?

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* 9. How do you store your alcohol? Skip this question if you answered No to question 8.

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* 10. On a scale of 1 – 10, how easy (1) or difficult (10) would it be to access alcohol from your home? Skip this question if you answered No to question 8.

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* 11. Are you aware of the Social Host Ordinance in your community (City of Santa Cruz, Santa Cruz County, Scotts Valley & Watsonville) which allows law enforcement to hold the host accountable for a gathering where alcohol is served to or consumed by minors?

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* 12. Your Age:

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* 13. What is your age?

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* 14. Your Zip:

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* 15. What is your zip code?