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Do you party with crystal meth?

yes no


If you do, about how many times have you used crystal in the last six months?

once or twice
three or four times
once a week
a couple of times a week
once a month
two or three times a month
daily


How do you do crystal?
(you can check more than one)

snort/bump
smoke
eat
inject/shoot
up the butt
other:


Where do you do crystal?
(you can check more than one)

home
bar/dance club
sex clubs/bathhouse
on the street
other:


Who do you do crystal with?
(you can check more than one)

alone
friends
sex partners(s)
lover
other:


What is your sex?

male
female
FTM
MTF


What is sexual orienation?

gay
bisexual
queer
straight
other:


How old are you?

What is your ethnicity?

African American
Asian/Pacific Islander
Caucasian
Latino
Native American
Multi-Cultural
Decline to State
other:


Please let us know where you are:
City:
State:
Zip:
Country:

Questions? Comments? Something else you'd like to say?