Survey Information

Thank you for participating in this survey! We are asking individuals between the ages of 18-25 years to share their opinions about alcohol, prescription drug misuse and heroin use. This survey is completely anonymous, and will be used to help inform prevention efforts in your community.

Important Information for Respondents

• This survey is completely anonymous and does not record any personal identifying information. Please answer all questions truthfully.

• The survey is completely voluntary. You may choose not to participate at any time. You may skip any questions you are not comfortable answering.

• The information from the survey will be released in summary form only. No individual responses will be shared.

• At the end of the survey you will be able to enter your name and email address to receive an Amazon $5.00 egift  card, which will be emailed directly to you within 5-7 business days.  Your contact information for the egift card will be collected in a separate location and can never be linked to your survey responses. You may only enter your information once; duplicate entries will be discarded.

If you have any questions or concerns about the survey, please contact Kenan Tyner-Smith, Prevention Coordinator for the Southside Community Services Board at 434-572-6916 Ext. 1550 or email: ksmith@ Or,
OMNI Institute Support at: or 303.839.9422. OMNI Institute is an organization working with coalitions across the state of Virginia to learn more about substance use among young adults.

Clicking the “Next” button below indicates that:
• You have read and understand the above information
• You voluntarily agree to participate
• You are between the ages of 18 and 25 years-old
• You are a Virginia resident