Grundy County Medication Take Back Survey (Version 2, 2018)
The Youth Advisory Committee at GAVC is working with the Behavioral Health Alliance of Grundy County to address the opioid overdose epidemic. We are gathering information on medication disposal behaviors of Grundy County residents to help gauge the need for increased disposal options and community education. This is the second year of the take back survey and we will be comparing the results from last year to this year's results. If you are a high school student or adult, please help us by answering a few questions.
What is your age range? *
How many adults, including yourself, (18 & up) live in your household? *
How many children below the age of 18, including yourself, live in your household? *
What is your gender? *
What high school district do you live in? *
What zip code do you live in? *
Your answer
Is prescription medication misuse a problem in your community? *
Do you know someone who suffers from addiction to prescription pain killers or other opioids such as heroin? *
Do you currently have prescription medications that you no longer need/use, are expired or unwanted in your home? *
How do you currently dispose of your unused, expired, or unwanted prescription medications? Please choose all that apply. *
Required
What are your top 2 concerns regarding your current method of disposal of prescription medications? Please choose no more than 2. *
Required
Are you aware of the prescription medication take back locations in Grundy County maintained by the Coroner’s Office? *
Have you used any of the prescription medication take back programs in Grundy County? *
Which of the following locations have you used to safely dispose of unwanted medications? (Choose all that apply) *
Required
What is the farthest distance you are willing to travel to properly dispose of your unused, expired, or unwanted prescription medications? *
How important is it for communities to offer take back locations, programs and events to reduce the amount of medications available for diversion and misuse? *
Do you know someone who is struggling with addiction? They can get help from the Illinois Helpline: 833-2FINDHELP or HelplineIL.org.
HelplineIL.org
Thank you. Below are the locations of unwanted medication take back bins managed by the Grundy County Coroner’s Office:
Grundy County Coroner’s Office
1320 Union St., Morris

Coal City Pharmacy
175 S. Broadway, Coal City

Coal City Police Dept.
545 S. Broadway, Coal City

Morris Police Dept.
200 East Chapin St., Morris

Minooka Police Dept.
121 East McEvilly Road, Minooka

Channahon Police Dept.
24555 S. Navajo Drive, Channahon

For more information about unwanted medication take back bins and programs in Grundy County, contact:
Grundy County Coroner’s Office
1320 Union St.
Morris IL 60450
(815) 942-3792

www.grundyco.org/coroner.

Submit
Never submit passwords through Google Forms.
This form was created inside of Grundy Area Vocational Center. Report Abuse - Terms of Service