Essex County Quality of Life Survey This voluntary survey will take less than five minutes to complete. Your responses will help guide us in building a healthy community. Thank you for your time! OK Question Title * 1. In which city do you live? I do not live in Essex County Belleville Bloomfield Caldwell Cedar Grove East Orange Essex Fells Fairfield Glen Ridge Irvington Livingston Maplewood Millburn Montclair Newark North Caldwell Nutley Orange Roseland South Orange Verona West Caldwell West Orange OK Question Title * 2. What is your age? Under 18 18-24 25-34 35-44 45-54 55-64 65-74 75+ OK Question Title * 3. What is your gender? Male Female Non binary OK Question Title * 4. Are you a parent or guardian? Yes No OK Question Title * 5. Overall, what issue in your community concerns you the most? OK Question Title * 6. I feel safe in my neighborhood. Yes No OK Question Title * 7. Do you think it would be wrong to provide alcohol to youth under the age of 21? Yes No OK Question Title * 8. Do you think it would be wrong for youth (under age 19) to use tobacco daily? Yes No OK Question Title * 9. Do you think it would be wrong to use marijuana daily? Yes No OK Question Title * 10. I believe that anyone under the age of 21 can drink alcohol in my home. Yes No OK Question Title * 11. Which of the following substances concerns you the most? (Check 1 answer) Alcohol Tobacco Marijuana Prescription Drugs Heroin OK Question Title * 12. In regard to prescription drug abuse, which of the following concerns you the most? (Check 1 answer) Unused medications not secured Link to heroin use Doctors are overprescribing Unused medications not disposed of OK Question Title * 13. In regards to underage drinking, which of these issues concerns you the most? (Check 1 answer) Binge drinking Stores providing alcohol to minors Alcohol poisoning Adults providing alcohol to minors OK Question Title * 14. Do you feel like you have enough information to talk with others about the dangers associated with drugs and alcohol? Yes No OK Question Title * 15. Would you be interested in learning more about teen alcohol or drug use? Yes No OK NEXT
