Question Title

Image
Join us in raising awareness of substance misuse in our communities when you participate in Green Up Day on May 1, 2021!  All are welcome to help out! 

Help us collect information about the impact of substances in our region:

1. Keep a count of how many substance-related items you find (if you see needles, don't touch them, notify local police if you find any).
2. Fill out this survey.
3. Take pictures of what you find and upload them to this survey. 

SAFETY FIRST! We recommend wearing gloves and that youth work with an adult. Please do not collect anything that could harm you and please take extra COVID-19 related precautions.

Name and Email required if you want to be entered into the drawing to win a $25 gift certificate to a local merchant.

For more information contact:
Brian Duda, Healthy Lamoille Valley, Youth Substance Prevention Coordinator
brian@healthylamoillevalley.org
(802) 448-2317

Question Title

1. Your Name (optional)

Question Title

2. Your Email Address (optional)

Question Title

3. Your Green-Up Town

Question Title

4. Please list the streets, parks, and other geographic regions you've worked on during Green-Up Day

Question Title

5. Number of cigarette butts you found

Question Title

6. Number of e-cigarette (vape) waste products you found

Question Title

7. Number of nips (little alcohol bottles) you found

Question Title

8. Number of alcohol bottles you found

Question Title

9. Number of alcohol cans you found

Question Title

10. Number of needles you found and where (DO NOT PICK UP!  Please notify law enforcement for best method of disposal)

Question Title

11. Was there a specific area that had a high concentration of substance related items? Please share details.

Question Title

12. During other times in the year, are there locations in your area where you notice substance related items being dumped? Please share type, amount and location.

Question Title

13. Please share any other thoughts or questions you have with us.  Thank you!

Question Title

14. Please upload any pictures of the substance-related items you found. Do not send pictures of anyone underage holding the products. 

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Thank you for filling out our survey!
Together We Create a Healthy Lamoille Valley!
Treatment and Recovery Resources: https://www.healthylamoillevalley.org/treatment-recovery/

For more information about the results of this survey or Healthy Lamoille Valley contact: 
Brian Duda, Healthy Lamoille Valley, Youth Substance Prevention Coordinator
brian@healthylamoillevalley.org
(802) 448-2317