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The Burlington Partnership for a Healthy Community, is a coalition who's mission is to positively impact the Burlington community by addresing the causes and consequences of substance abuse. We are gathering information on drug disposal behaviors of Burlington residents to help gage the need for increased disposal options and community education. All answers will be kept confidential, and will be only for research and funding application purposes. Some questions have duel parts,. please read carefully and answer both parts of the question. We thank you for your participation!

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* 1. Do you currently have prescription medications that you no longer need/use, are expired or unwanted in your home?

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* 2. How do you currently dispose of your unused, expired, or unwanted prescription medications? Please choose all that apply.

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* 3. What are your top 2 concerns regarding your current method of disposal? Please choose only 2.

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* 4. Are you aware of the prescription drug take-back program at the Burlington Police Department?

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* 5. Do you use the prescription take-back program at the Burlington Police Department?

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* 6. How far are you willing to travel to properly dispose of your unused, expired, or unwanted prescription drugs?

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* 7. In recent years, there has been an increase in home invasions, as well as burglaries to pharmacies and veterinary offices by known prescription drug seekers/abusers. How much do you feel this issue concerns you?

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* 8. What is your age range?

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* 9. How many people live in your household and what are their ages?

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* 10. What is your gender?

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