Inter-Faith Workshop Survey Pre-Test
We are interested in understanding what you learn from your participation in this workshop.  Please answer the following questions as best you can.  At the conclusion of the workshop we will ask you to fill out a similar questionnaire.  Your answers are confidential.  Thank you for taking the time to fill out the questionnaire.
a.  Are you: Male     Female
b.  Date of Birth:
c.  What do you consider yourself to be? (Choose one best answer)

Specification for Other:

d.  Which faith do you identify with?

Specification for Other:

1.  Which of the following is true?

 
2.  Who among the following is "safe" from developing a drinking problem?
3.  Jennifer's parents come to you concerned she has a drinking problem because they have discovered she has been drinking for the past month.  From this, you deduce:
4.  I feel comfortable discussing substance use issues with members of my congregation.
5.  It is important to discuss substance use with my congregation.
6.  I feel confident recognizing the signs and symptoms of problematic substance use.
7.  I know what to do if I feel someone needs substance abuse treatment.

  Thank you!