Parent Survey

The SAFIR Coalition is a prevention coalition in Indian River County that addresses substance abuse among youth including underage drinking, marijuana use and prescription drug misuse. As a parent of a youth in our community, your thoughts, insights and opinions are very important to the SAFIR Coalition. We think it's important to understand what parents are saying. Please take a few moments and complete the survey to let us know what you believe about youth substance use in Indian River County. The information will be used in our strategic planning and to make positive change in Indian River County.

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* 1. What town do you live in?

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* 2. What is your Race?

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* 3. What is your ethnicity?

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* 4. What grade is your child(ren) in?

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* 5. In you opinion, what issues do you see as a problem in your community (rank from 1 to 4 with 1 being the highest issue) Use each number only one time and fill in each box.

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* 6. How harmful do you think the following are:

  Very Harmful Somewhat Harmful Harmful Not Harmful Unsure
Underage Drinking
Youth Marijuana Use
Prescription Medication Misuse
Youth E-Cig/Vaping use

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* 7. How often do you talk to your child about your disapproval of the following:

  Daily Once a week Several times a month Once a month Several times a year Once a year Never
Underage Alcohol Use
Marijuana Use
Prescription Drug Misuse
E-Cigarettes/Vaping

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* 8. If your teen was going to a party where you think there might be alcohol, what would you do?

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* 9. How do you monitor alcohol in your home?

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* 10. Where do you store your prescriptions?

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* 11. How do you dispose of unused, expired medication?

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* 12. What information would be of interest to you to learn about? (check all that apply)

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* 13. If a presentation was held on the above topics of interest, would you attend and when is the best time for you to come?

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* 14. If you would like to be part of SAFIR or put on our mailing list for upcoming events, please list your information below.

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