Parent and Community Member Needs Assessment Survey

Para cambiar el idioma de la encuesta al español, seleccione Español en la esquina superior derecha.
Thank you for taking the time to complete this survey!

The purpose of this survey is to better understand your community's needs. The survey will take about 5 minutes. Please only take this survey one time. Your participation is greatly appreciated.
1.Are you a parent or caregiver to a child under the age of 18?(Required.)
2.What county do you live in?(Required.)
3.What is your zip code?(Required.)
4.What is your age?(Required.)
5.Which factors do you believe most contribute to substance use and behavioral health challenges in our community? Select up to 3(Required.)
Privacy & Cookie Notice