Nebraska Youth Screen - Youth Version
As a juvenile cited by law enforcement, the Otoe County Attorney's Office would like certain information from you and a parent/guardian before proceeding with any criminal or juvenile court prosecution or diversion. You will be asked questions from the Nebraska Youth Screen to aid in the processing of this matter. A separate survey link must be completed by a parent/guardian. Please complete w/in 1 week of receiving your citation. If you are having difficulty with the survey please contact (402) 969-0319 or email
Email *
Phone: (confirmation sent via email and/or text) *
First & Last Name: *
Gender: *
Race/Ethnicity: *
Age at time of offense: *
Offense (if more than one, select the top listed offense from your citation): *
Briefly describe how you received this offense. *
Offense Date (approximate if need) *
Have you received any other offenses prior to this incident? *
Please list prior offenses and dates if known (or indicate None). *
Have you received any diversion or probation services in the past, in any county? *
Education *
How many days of school have you missed in the last 2 weeks? *
Were you under the influence of any substance at the time of your offense? *
In the past 3 months how OFTEN did you use Cigarettes/Vape products? *
In the past 3 months how OFTEN did you use Marijuana/THC products? *
In the past 3 months how OFTEN did you consume Alcohol? *
Are you employed or involved in extra-curricular activities currently? *
Have you completed community service or volunteered in the past? *
Overall, how do you feel about the offense you were cited for? *
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