Take our Survey

Needle Exchange Survey

Please take our quick, easy, unofficial Needle Exchange Survey. I will use the survey results in discussions on the radio, with county officials, and elsewhere. Your information is private and only aggregated data will be shared in a summary format.

1) Are you a resident of Santa Cruz County, California or a city within the boundaries of the county?

	Yes
	No

2) Are you 18 years of age or older?

	Yes
	No

3) Should the County of Santa Cruz Health Services Agency provide hypodermic needles to intravenous (IV) drug users?

	Yes
	No

4) Should groups other than the County HSA provide needles to IV drug users?

	Yes
	No

5) If yes to either of the needle provider questions above, how many needles should the user be able to get?

	Unlimited
	1 used : 30 new - exchange
	1 used : 1 new - exchange

Other, please specify

6) Should the County HSA distribute these other items as part of the needle exchange? Please check all with which you agree

7) Please add any other ideas or thoughts you may have

8) Please help with demographic categorization of answers. Are you male or female?

	Male
	Female

9) Age category:

	18-34 years of age
	35-54
	55-74
	74+

10) IV drug use:

	Never
	Used to be/Recovering
	Current

Please provide your email