Drug and Alcohol Use Survey

Gender *

Female

Male

Required

What grade are you in? *

9

10

11

12

Required

Have you ever used alcohol and/or drugs in your lifetime? *

Yes

No

Required

Have you ever been peer presured into using drugs and/or alcohol? *

Yes

No

Required

Have you ever wanted to use drugs and/or alcohol? *

Yes

No

Required

Why do you fell the need to do drugs and/or alcohol? *

I don't feel the need

Peer pressure

It is cool

Other

Required

How often do you use drugs and/or alcohol? *

Never

Sometimes

Often

Every day

Required