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Drug and Achohol use Survey
Please complete the survey. Your responeses will reamin anonymous.
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* Indicates required question
Gender
*
Female
Male
Required
What grade are you in?
*
9
10
11
12
Required
Have you been put in the situation to be pressured into drugs?
*
Yes
No
Required
Have you tried to convince anyone to try drugs?
*
Yes
No
Required
Are you planning on drinking when you become of age?
*
Yes
No
Not sure yet
Required
Does anyone in your family drink or use drugs?
*
Yes
No
Required
Which of these are drugs?
*
Alchohol
Caffeine
Both option 1 and 2
Required
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