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!

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* 1. It is okay for parents and other adults to allow underage drinking in their home.

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* 2. It is okay to allow underage drinking in private homes as long as it is in a controlled setting (e.g. car keys are collected, designated drivers are assigned).

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* 3. I am aware of neighbors or other adults who allow underage drinking in their home.

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* 4. I allow underage drinking in my home.

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* 5. I monitor the amount of alcohol in my home on a regular basis.

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* 6. I believe that alcohol laws/regulations (e.g. carding for 21 at retail stores and bars) are enforced regularly in my community.

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* 7. I believe that alcohol is bad for an adolescent’s brain.

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* 8. I am aware of youth who use prescription drugs without a prescription.

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* 9. The proper way to dispose of prescription and/or over-the-counter drugs is by flushing them down the toilet.

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* 10. I monitor and secure the medications in my home.

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* 11. It is okay to take someone else’s prescription drug.

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* 12. Prescription drugs can be just as dangerous as street drugs.

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* 13. I know where to get information on alcohol, tobacco, and other drugs.

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* 14. If there was a local place to discard expired or unused medications at no cost, I would regularly use this service.

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* 15. I believe that marijuana can be just as harmful as alcohol.

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* 16. I believe that vaping is harmful.

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* 17. Are you a parent, grandparent or guardian providing a home for a child or children under age 21?

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