Cocaine Anonymous UNITED KINGDOM AND IRELAND
This is a membership survey of Cocaine Anonymous in the United Kingdom and Ireland. It’s an anonymous survey created by your PI committee.

Surveys are conducted periodically to collect information about the demographic of our membership and to find areas of potential growth.

We will NOT collect any personal identifying data, however by completing this form you are giving consent for your answers to be included in a final report with will be shared in Fellowship and used to inform PI and Area Service Committees where their efforts could be focused.

This survey will be open until 31.10.18

Which CA area are you a part of? *
Which District are you a part of? *
Your answer
Do you have a home group? *
How many group members does your home group have? (not attendees - actual group servants - GSR, tea person, greeter, literature person etc ) *
Your answer
What is your age group? *
What is your gender? *
Required
What is your current employment status? *
What mind altering substances did you primarily use? (Tick all that apply) *
Required
How did you find out about CA? *
Where did you FIRST start looking for help with your addiction?
How many meetings do you attend per week *
Do you have a sponsor? *
Have you taken all 12 steps? *
What length of continuous sobriety do you have? *
What level of service do you currently participate in for CA?
What level of service have you previously participated in for CA *
Required
If you have never participated in service at District or Area level, please tell us why not
Is there anything else you’d like to tell us?
Your answer
In the spirit of Tradition 6, Cocaine Anonymous is not affiliated with any outside enterprise and neither endorses or opposes any causes.
THANK YOU FOR HELPING TO CREATE THE FELLOWSHIP YOU CRAVE
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