Addiction/Recovery Survey

First Name

Last Name

Date

Phone/Mobile

1. Share your thoughts about substance use in your community.

2. What do you consider the biggest concerns related to substance use in your community?

3. What would you say contributes to this issue here? Why is substance use an issue in this community?

4. What services are you aware of that are currently available for individuals in your community when it comes to substance use?

5. What specific agencies and programs are you aware of (or who do you work with) to address substance use concerns in your community?

6. What additional resources do you think are needed here?

7. How do you feel about recovery supports (support group meetings, Medication-Assisted Recovery, etc.) that are offered in your community?

8. Can we county on your support increasing recovery supports in this area? How can you (and your agency, if applicable) get engaged?

9. Who else would you recommend I speak to in your community?