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* 1. What is your age?

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* 2. What is your gender?

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* 3. Which race/ethnicity best describes you? (Please choose only one.)

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* 5. Do you currently attend any type of self help meeting?

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* 6. What did you find most helpful about self help meetings?

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* 7. What did you find least helpful about self help meetings?

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* 9. If you do not attend self help meetings why did you stop?

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* 12. Do you currently smoke cigarettes, or vape?

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* 13. Do you currently take a mood altering prescription?

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* 14. Do you currently take any illegal drugs?

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* 15. Who or what is your greatest support for your life changes?

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* 16. How do you support you life style changes?

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* 17. Are you in therapy?

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* 18. Do you meditate?

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* 19. Do you utilize a prayer life?

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* 20. Do you exercise?

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* 21. Please list any method not mentioned that use to enhance your life? 

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* 22. Rate you level of contentment with your life today?

  Very content Somewhat content Neutral Somewhat discontent Very discontent
Contentment level of life

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* 23. Do you believe a person can return to controlled use after being identified as addcited?

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* 24. Could we contact you you for future surveys?

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* 25. At what email address would you like to be contacted?

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