JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
DRUGS AND ADDICTIONS
We value your privacy, so your answers will stay anonymous.
* Indicates required question
What's your gender identification?
*
Male
Female
Nonbinari
Other:
How old are you?
*
Your answer
Did you know that tobacco and alcohol are drugs as well?
*
Yes
No
Do you consume alcohol or tobacco?
*
Yes
No
How much alcohol do you consume per week? (in approximate liters)
*
Your answer
How many cigarettes do you smoke in a week?
*
Your answer
Do you have tobacco consumers in your family?
*
Yes
No
I don't know
Do you have drug consumers in you family? (
alcohol and tobacco do not count as drugs
)
*
Yes
No
I don't know
Have you ever consumed drugs?
*
Si
No
Have you ever accepted drugs from a friend?
*
Yes
No
Yes, but I didn't consume
Do you know the side effects of any drug?
*
Si
No
Have you ever seen anyone need help because of drug's side effects?
*
Yes
No
Why do people do drugs if they know it's bad?
*
Your answer
How many types of drugs do you know? (
number
)
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Institut Moianès.
Report Abuse
Forms
