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* 1. What School does your child attend?

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* 2. Which grade is your teen in school?

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* 3. What ethnicity do you identify with? Check all that apply. (Required due to receipt of grant funding)

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* 4. When was the last time you talked to your teen about not using alcohol?

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* 5. How often do you think other parents/guardians and their teens talk about alcohol use?

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* 6. Do you have clear rules against:

  Yes No
Alcohol Use
Marijuana Use
Vaping

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* 7. Do you think other parents/guardians have rules against alcohol use for their teens?

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* 8. Where do YOU as a parent/guardian get your information regarding alcohol, marijuana or vaping? (check all that apply)

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* 9. In our community, teenage use of the following substance is a problem...

  Strongly Agree Agree Disagree Strongly Disagree
Alcohol
Marijuana
Vaping

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* 10. Do you know other parents/guardians/adults who host parties where alcohol is available or served to teenagers?

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* 11. Do you know that you are liable if teens use alcohol on your property, even if you are not present?

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* 12. Do you host parties where alcohol is available or served to teenagers?

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* 13. Do you think other parents/guardians know they are liable if teens use alcohol on their property, even if they are not present?

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* 14. Has your teen been to a friend's house or party where alcohol was available or served to them?

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* 15. If you knew your teenager was going to a party where alcohol might be available or served, how likely would you be to let them go?

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* 16. How likely do you think other parents/guardians would be to let their teen go to a party where alcohol might be available or served?

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* 17. Have you ever had to address your child's own use of alcohol with him/her?

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* 18. Has your teen been to a friend's house or party where marijuana was available to them?

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* 19. If you knew your teenager was going to a party where marijuana might be available, how likely would you be to let them go?

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* 20. Which statement below best represents your attitude about teens drinking alcohol?

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* 21. Which statement below best represents your attitude about teens using marijuana?

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* 22. Which statement below best represents your attitude about teens vaping?

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* 23. Would you know if your child had been....

  Yes No Maybe
Drinking Alcohol
Using Marijuana
Vaping

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* 24. Would you like to learn more about the impact of marijuana use (vaping, smoking, edibles) and teens?

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* 25. During the past year, do you remember seeing or hearing any local alcohol prevention advertisements, posters, or signs?

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* 26. During the past year do you remember seeing any alcohol prevention messages that included local data or percentages as a part of the message?

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* 27. Do you remember seeing the following banner or poster at your child's school?

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* 28. Do you remember seeing the following banner or poster at your child's school?

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* 29. How would you like to receive teen drug and alcohol prevention education? Select all that apply. 

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