100%
Questions marked with a * are required Exit Survey
 
 
* Have you ever used an opioid medication to get high?
 
Yes
 
No
 
Uncertain
 
 
 
* Have you or a member of your immediate family (father, mother, brother, sister) been prescribed an opioid medication during the past twelve months?
 
Yes
 
No
 
Uncertain
 
 
 
* Do you know someone who is using opioid medication to get high?
 
Yes
 
No
 
Uncertain
 
 
 
* Do you know someone who is using heroin or fentanyl to get high?
 
Yes
 
No
 
Uncertain
 
 
 
* Do you know anyone who has died from an overdose?
 
Yes
 
No
 
Uncertain
 
 
 
* Have you considered using either opioid medication or heroin to get high?
 
Yes
 
No
 
Uncertain
 
 
 
* After today’s presentation:
 
I am less likely to use opioid medication or heroin to get high.
 

I am more likely to use opioid medication or heroin to get high.

 
My intention to use is the same.
 
 
 
* What did you like best about today’s presentation?
   
 
 
 
* What did you like least about today’s presentation?
   
 
 
 
* What was missing from today’s presentation?
   
 
 
 
* What grade are you in?
 
 
 
* What is your gender?
 
Male
 
Female
 
 
 
* What is your ethnicity?
 
 
 
* May we contact you via email to provide information about our upcoming events? We value your input and promise that ALL information is strictly confidential and will not be shared.
 
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