TheAAC.co.za visitor survey.

Please answer all the questions honestly.All submissions will remain 100% confidential.
Full Names (optional)
Your Email Address (optional)
Age *
Sex *
Province *
Are you emploed *
Are you struggling a dependency? *
Why did you visit our site? *
How did you find us? *
Did you find what you were looking for? *
What would you like more info on?
Where must we send it to? (emaill address)
Must sin tax be used for treatment costs? *
Who is accountable for treatment costs? *
Have you used drugs before? *
Are you using drugs now? *
Do you have children? *
How many? *
Marital status *
Have you finished high school? *
Do you have a tertiary education? *
Do you drink alcohol? *
Do you smoke cigarettes? *
Are you considering using drugs or alcohol? *
Do you think you have a problem with.. *
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