Nevada Urban Indians Inc. Partnership for Success Program Older Youth Substance Use Survey 14yr-20yr
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What is your age
What school do you go to *
What is your gender *
What race or ethnicity do you identify as... select all that apply *
Required
Have you ever used alcohol *
At what age did you first use alcohol
Have you ever used drugs *
At what age did you first use drugs
Do your friends use drugs or drink alcohol *
How often do they use drugs or alcohol
Do your parents use drugs or drink alcohol *

Have you or a family member visited the ER or Hospital due to using any drugs or drinking alcohol in the past year

 *

Would you be interested in participating in the following events: Roller Skating, Camping Trips, Escape Rooms, Dance Parties, Arts and Crafts, and many more fun activities

 *

What do kind of events would you like to attend? What are you interested in

If you are interested in participating in the above events and more, please provide your name, phone number, and email address.

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