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Community Alcohol Survey-Adopted from FACE
This survey will provide information on the availability, density, marketing, consumption, and prevention of underage age alcohol and adult over consumption. Thank you for your time.
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* Indicates required question
Please identify below if you are youth or adult completing the survey?
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Youth
Adult
If you identified as an adult above, which sector do you belong to below (choose as many as you like).
Parents
Business
Media
Schools
Youth-serving organization
Law enforcement/Public safety
Religious or fraternal organizations
Civic or volunteer group
Healthcare professional
State, local, or tribal governmental agencies with expertise in substance misuse
Other organizations involved in reducing substance misuse (treatment providers)
Person in Recovery
Mental Health
Are there opportunities to engage in healthy, alcohol-free activities in the community?
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Yes
No
Are special events such as rodeos, community fairs or car shows in your community alcohol free? If no please complete the next four questions.
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Yes
No
If not are there non-alcohol related activities available?
Yes
No
Clear selection
Are non-alcoholic beverages available?
Yes
No
Clear selection
Are ID's checked when a person purchases an alcoholic beverage
Yes
No
Clear selection
Are adults consuming more alcoholic beverages at these events?
Yes
No
Clear selection
Are beer/alcohol bottles littering neighborhoods or other areas of the community?
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Yes
No
Are activities such as red-ribbon week, the Great American Smoke out, Drinking and Driving Awareness, Underage Drinking Awareness or AIDS campaigns advertised and promoted within the community?
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Yes
No
Is there a community coalition on alcohol issues?
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Yes
No
Do students know what their school policies are regarding student alcohol use?
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Yes
No
Do students know the consequences of breaking school polices related to alcohol use?
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Yes
No
Do parents support school policies on alcohol?
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Yes
No
Do students support alcohol policies on alcohol?
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Yes
No
Do students believe adults will experience consequences if they assist or enable students who violate school alcohol policies?
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Yes
No
Do students think polices are consistently enforced?
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Yes
No
Does your school have a student handbook available that identifies alcohol policies?
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Yes
No
Do students think that alcohol use contributes to their problems? (Problems may include low grades, suspension from school, problems with parents and/or teachers or problems with the law.)
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Yes
No
Do students distribute handouts or fliers for parties where alcohol will be available?
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Yes
No
Are there health promotion posters visible at school? (health promotion posters might include topics such as not smoking, or using tobacco products, having a healthy diet and not using drugs or alcohol)
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Yes
No
Does your school have a student assistance program?
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Yes
No
How many retail convenience stores are located in your community?
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Your answer
How many of the retail convenience stores sell alcoholic beverages other than beer (wine, liquor, pre-mixed alcohol)
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Your answer
Is beer located in coolers next to soda pop and milk?
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Yes
No
Are there any signs posted stating that a person must be 21 to purchase and/or consume beer/alcohol?
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Yes
No
Are there any promotional alcohol displays? If yes answer next question to the best of your ability.
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Yes
No
How many?
Your answer
Do promotional alcohol displays have raffles or drawings to win something?
Yes
No
Clear selection
Are promotional alcohol displays placed below the eye-level of an adult, where children can easily view it?
Yes
No
Clear selection
Are convenience store cluttered with alcohol advertisements?
Yes
No
Clear selection
Do you have designated liquor stores in your community that specifically sell package liquor store in your community?
Yes
No
Clear selection
How many package liquor stores are in the community?
Your answer
Do liquor stores have signs stating that a person must be 21 to enter?
Yes
No
Clear selection
How many bars (which can include separate bar areas located inside a restaurant or stand alone bar) are located in the community?
Your answer
Are bars, liquor stores or convenience stores that sell alcohol located near neighborhoods or schools?
Yes
No
Clear selection
Do alcohol outlets in your community target students in their advertisements and promotions?
Yes
No
Clear selection
Do bars feature advertising that promote high-risk drinking, such as price discounts or happy hour?
Yes
No
Clear selection
How many billboards are there in the community?
Your answer
How many billboards in the community advertise alcohol?
Your answer
Are convenience stores cluttered with alcohol advertisements on the windows?
Yes
No
Clear selection
How many (average)?
Your answer
Do local businesses carry alcohol-related merchandise? (e.g., beer mugs, shot glasses, t-shirts with alcohol logos)
Yes
No
Clear selection
Does merchandise such as posters or clothing have pro-drinking messages?
Yes
No
Clear selection
Does merchandise such as posters or clothing have health promotion messages?
Yes
No
Clear selection
Are local business littered with beer bottles and cans?
Yes
No
Clear selection
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