The Tehama County Maternal Child Adolescent Health Program is doing this survey as part of a community needs assessment to help us to find out more about health needs in our communities. This is a survey about health-related behaviors, risks, and attitudes. It includes questions about diet and physical activity, use of alcohol, tobacco, and other drugs, and safety and violence. You do not have to answer all these questions but we hope that you will. The information you give will be used to develop better health education for young people like yourself. Please do not write your name on this form. The answers you give will be kept private. Do not identify yourself in any other way. Please check all your answers. Mark only one answer unless told to do so otherwise. This survey asks about things you have done during different periods of time, such as during your lifetime (for example, did you ever do something), and the past year, six months, or 30 days. Each is asked for a different reason and provides different information. Please pay careful attention to these time periods and answer all questions.
Thank you for completing this survey.