Exit Survey
You have been invited to participate in this community survey to gather your perceptions on substance abuse and prevention efforts in Jay County. If you live or work in Jay County, we hope you'll take some time to complete this survey; it shouldn't take longer than 10-15 minutes. 

Upstream Prevention, Inc. is serving as evaluator and collecting the data to assist in prevention planning in the community. No survey responses will be shared in an identifiable manner. A report identifying aggregate information provided will be produced by the Evaluator (Upstream Prevention), which may be made available to the public at the coalition's discretion. All reports provided to the coalition will be in an anonymous format. Your participation in this survey is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can skip any question or withdraw from the survey at any point.

Upon completion of the survey, you will be taken to another survey with the option to provide contact information to be entered into a drawing for an Amazon gift card. Your contact information will be kept by the evaluator on a secure server, unless you also identify it should be shared with the coalition to receive more information. Only those who identify their information should be shared, and/or the winner of the random drawing, will have their information shared with the coalition.

Thank you very much for your time and support. If you have any questions, please don't hesitate to reach out to Upstream Prevention (michaela @upstreamprevention.org). Please start with the survey now by clicking on the button below.