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Surveys
2015
April
M
Mental Health
Mental Health
0%
Exit Survey
How old are you?
15-24
25-34
35-44
45-54
55-64
65+
What is your gender
Male
Female
She-Male
Something else unclassified
Do you believe that you may be mentally challenged?
Yes
No
My doctor believes so
Check my records
Have you ever smoked Marajuana
Yes
No
Maybe
What was the question?
Have you ever stolen anything in your life?
Yes
No
Maybe
Marital Status?
Single
Married
Divorced
Just out of Jail
Transgender
Bi-Sexual
Horses Hoof
Why do you think you have been selected for this survey
Because I am spun!
Because I am part of tribe!
Because I fit in with the mentally disturbed!
Do you have a genetic disorder?
Yes
No
I think so
Have you ever been committed?
Yes
No
Have you ever been prescribed Anti-Depressants?
Yes
No
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