SECTION: Health Care Coverage and Utilization Survey Entry ...
SECTION: Health Care Coverage and Utilization Survey Entry ...
SECTION: Health Care Coverage and Utilization Survey Entry ...
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<strong>Survey</strong> <strong>Entry</strong> - 2011 College Student <strong>Health</strong> <strong>Survey</strong>http://internetstudy.cbsol.com/<strong>Survey</strong>/B<strong>Survey</strong>.asp<strong>SECTION</strong>: Chemical <strong>Health</strong>12 SURVEY PAGE: 12 of 26 pages You have completed 0 of 20 Items on this page1 During the past 12 months, howoften have you used:**(Mark one for each line)**Did not useOnce/year6times/yearOnce/monthMore thanonce/monthSmoking tobaccoSmokeless tobaccoAlcohol (beer, wine, liquor)Marijuana (pot, hash, hash oil)Cocaine (crack, rock, freebase)Amphetamines (meth, speed)SedativesHallucinogens (LSD, PCP)Opiates (heroin)Inhalants (glue, solvents, gas)EcstasyPerformance enhancing steroidsGHB, Rohypnol (or other club drugs)Prescription drug not prescribed for youTobacco from a water pipe (hookah)2 During the past 30 days, on howmany days did you use:**(Mark one for each line)**0 days 1-2 days 3-5 days 6-9 days10-19days20-29daysAll 30daysSmoking tobaccoSmokeless tobaccoAlcohol (beer, wine, liquor)Marijuana (pot, hash, hash oil)Tobacco from a water pipe (hookah)SUBMIT RESPONSES - Updates will be saved. You will be taken to the ANSWER REVIEW PAGE.SKIP THIS PAGE - No updates will be saved. You will be taken to the OVERALL SURVEY SUMMARYPAGE.1 of 1 5/10/11 3:02 PM
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