Healthy BTV Community Feedback Form

Healthy BTV invites you to share your experiences about how you are impacted by substance use in Burlington. Healthy BTV is a project of Burlington’s substance misuse prevention coalition, the Burlington Partnership for a Healthy Community and we are interested in hearing from folks in the community to better understand what is happening to develop strategies to prevent substance misuse and increase health and wellness in Burlington. 

We appreciate your time! Your answers will be kept anonymous unless you give us specific permission to share. 

If you have specific questions about this form or want to learn more about Healthy BTV reach out to our Associate Director at Bianka@burlingtonpartnership.org 

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What are specific resources, opportunities, or other things you see in Burlington that you think are supporting young people?
If you could add one new resource or opportunity to support health and wellness in Burlington, what would it be?
What are you seeing in your community, school or personal life that may be contributing to misuse of substances in Burlington? Please try to be specific.  

Are there local attitudes or culture around alcohol, cannabis, tobacco or other substance use that you see?  Is it specific to a particular group/population?

Have you seen examples in Burlington of how current local policies or community design might be influencing substance use? (positively or negatively) If yes, please share what you are seeing.

Complete the sentence:  “I would be really excited if Burlington helped to improve ___________.” 

May we use a quote from your responses above in our work? (We do not have to use your name.)
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Please share your name and email/phone here if you are okay with us using your name with your quote. 
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