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  2. 2017
  3. February
  4. E
  5. Effects of Risky Behavior on Academic Achievement
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Exit Survey
 
On how many occasions (if any) have you smoked cigarettes?
0 1-2 3-5 6-9 10-19 20-39
In your lifetime
During the last 6 months
During the last 30 days
 
 
 
What grade are you in?
 
12th Grade
 
11th Grade

 
 
 
How old are you?
 
16
 
17
 
18
 
19
 
 
 
What is your gender
 
Female
 
Male
 
Transgender

 
 
 
Have you ever used any of the following Opiods? (select all the apply)
 
Heroin
 
Perscription Pain Killers (not perscribed to you)
 
Morphin (not perscribed to you
 
Methadone

 
 
 
Have you ever used any of the following Hallucinogens? (select all the apply)
 
Mushrooms
 
LSD
 
Mesciline

 
 
 
Do you feel that you are currently addicated to drugs and/or alcohol?
 
Yes
 
No
 
 
 
Have you ever been arrested?
 
Yes
 
No
 
 
 
What are your plans after high school graduation?
 
University
 
Community College
 
Vocational School
 
Getting a Job
 
Don't Know
 
 
 
How old where you when you first drank alcohol