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!

What is your age?

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* 2. What is your age?

What is your gender?

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* 3. What is your gender?

Are you a parent or guardian?

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* 4. Are you a parent or guardian?

Overall, what issue in your community concerns you the most?

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* 5. Overall, what issue in your community concerns you the most?

I feel safe in my neighborhood.

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* 6. I feel safe in my neighborhood.

Do you think it would be wrong to provide alcohol to youth under the age of 21?

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* 7. Do you think it would be wrong to provide alcohol to youth under the age of 21?

Do you think it would be wrong for youth (under age 19) to use tobacco daily?

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* 8. Do you think it would be wrong for youth (under age 19) to use tobacco daily?

Do you think it would be wrong to use marijuana daily?

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* 9. Do you think it would be wrong to use marijuana daily?

I believe that anyone under the age of 21 can drink alcohol in my home.

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* 10. I believe that anyone under the age of 21 can drink alcohol in my home.

Which of the following substances concerns you the most? (Check 1 answer)

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* 11. Which of the following substances concerns you the most? (Check 1 answer)

In regard to prescription drug abuse, which of the following concerns you the most? (Check 1 answer)

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* 12. In regard to prescription drug abuse, which of the following concerns you the most? (Check 1 answer)

In regards to underage drinking, which of these issues concerns you the most? (Check 1 answer)

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* 13. In regards to underage drinking, which of these issues concerns you the most? (Check 1 answer)

Do you feel like you have enough information to talk with others about the dangers associated with drugs and alcohol?

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* 14. Do you feel like you have enough information to talk with others about the dangers associated with drugs and alcohol?

Would you be interested in learning more about teen alcohol or drug use?

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* 15. Would you be interested in learning more about teen alcohol or drug use?

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