This free survey is powered by QUESTIONPRO.COM
0%
Exit Survey »
 
 
how old are you ?
   
 
 
 
select your gender ?
 
male
 
female

 
 
 
are you in emotional relationship ?
 
yes
 
no

 
 
 
Did you use legal OR illegal drugs ?
 
legal drugs
 
illegal drugs
 
both
 
 
 

 
 
 
How do you feel when you take drugs ?
 
numbness
 
excitement
 
relaxation
 
senseless
 
none

 
 
 
Do you consider yourself one who takes drugs ?
 
yes
 
no

 
 
 
The first person that made you try to take drugs is
   
 
 
 
Did you start taking drugs to rebel from your life conditions or for the fun of it ?
 
yes
 
no

 
 
 
Do you have any family problems ?
 
yes
 
no

 
 
 
In your opinion , do you think that taking drugs as a self medication is a reason to solve your life stress ?
 
yes
 
no

 
Survey Software Powered by QuestionPro Survey Software