Unbelievable surveys given to children in Massachusetts -- and schools across America

How old are you?
A.  12 years old or younger
B.  13 years old
C.  14 years old
D.  15 years old
E.  16 years old
F.  17 years old
G.  18 years old or older

=== Sexual Behavior ===

Which of the following best describes you?
A.  Heterosexual (straight)
B.  Gay or lesbian
C.  Bisexual
D.  Not sure

A transgender person is someone whose biological sex at birth does not match the way they think or feel about themselves. Are you transgender?
A.  No, I am not transgender
B.  Yes, I am transgender and I think of myself as really a boy or man
C.  Yes, I am transgender and I think of myself as really a girl or woman
D.  Yes, I am transgender and I think of myself in some other way
E.  I do not know if I am transgender
F.  I do not know what this question is asking

Have you ever had sexual intercourse (oral, anal, vaginal)?
A.  Yes
B.  No

How old were you when you had sexual intercourse (oral, anal, vaginal) for the first time?
A.  I have never had sexual intercourse
B.  11 years old or younger
C.  12 years old
D.  13 years old
E.  14 years old
F.  15 years old
G.  16 years old
H.  17 years old or older

During your life, with how many people have you had sexual intercourse (oral, anal, vaginal)?
A.  I have never had sexual intercourse
B.  1 person
C.  2 people
D.  3 people
E.  4 people
F.  5 people
G.  6 or more people

During the past 3 months, with how many people did you have sexual intercourse (oral, anal, vaginal)?
A.  I have never had sexual intercourse
B.  I have had sexual intercourse, but not during the past 3 months
C.  1 person
D.  2 people
E.  3 people
F.  4 people
G.  5 people
H.  6 or more people

Did you drink alcohol or use drugs before you had sexual intercourse (oral, anal, vaginal) the last time?
A.  I have never had sexual intercourse
B.  Yes
C.  No

The last time you had sexual intercourse (oral, anal, vaginal), did you or your partner use a condom?
A.  I have never had sexual intercourse
B.  Yes
C.  No

During your life, with whom have you had sexual contact?
A.  I have never had sexual contact
B.  Females
C.  Males
D.  Females and males

How many times have you been pregnant or gotten someone pregnant?
A.  0 times
B.  1 time
C.  2 or more times
D.  Not sure   

Have you ever been tested for HIV, the virus that causes AIDS? (Do not count tests done if you donated blood.)
A.  Yes
B.  No
C.  Not sure

Have you ever been tested for other sexually transmitted diseases (STDs) such as genital herpes, chlamydia, syphilis, or genital warts?
A.  Yes
B.  No
C.  Not sure

=== Family and personal life ===

How often does your parent/guardian(s) wear a seat belt when driving or riding in a car?
A.  Never
B.  Rarely
C.  Sometimes
D.  Most of the time
E.  Always

Do your parents text, e-mail or use any other form of social media while driving a car or other vehicle?
A.  Yes
B.  No

Can you talk with at least one of your parents or other adult family members about things that are
important to you?
A.  Yes
B.  No

My parent/guardian(s) talk to me about the dangers of alcohol and drugs?
A.  Yes
B.  No

Is there at least one teacher or other adult in this school that you can talk to if you have a problem?
A.  Yes
B.  No

During the past 12 months, how  often did you talk with your parents  or other adults in your family about  sexuality or ways to prevent HIV  infection, other sexually transmitted  diseases (STDs), or pregnancy?
A.  Not at all during the past 12  months
B.  About once during the past  12 months
C.  About once every few  months
D.  About once a month
E.  More than once a month

How long have you lived in the United States?
A.  Less than 1 year
B.  1 to 3 years
C.  4 to 6 years
D.  More than 6 years but not my whole life
E.  I have always lived in the United States

Where do you typically sleep at night?
A.  At home with my parents or guardians
B.  At a friend's or relative's home with my parents or  guardians
C.  At a friend's or relative's home without my parents or  guardians
D.  In a supervised shelter with  my parents or guardians
E.  In a supervised shelter  without my parents or  guardians
F.  In a hotel or motel, car, park, campground, or other public  place with my parents or  guardians
G.  In a hotel or motel, car, park, campground, or other public  place without my parents or guardians
H.  Somewhere else

=== Weapons ===

During the past 30 days, on how many days did you carry a weapon such as a gun, knife, or club?
A.  0 days
B.  1 day
C.  2 or 3 days
D.  4 or 5 days
E.  6 or more days

During the past 30 days, on how many days did you carry a gun?
A.  0 days
B.  1 day
C.  2 or 3 days
D.  4 or 5 days
E.  6 or more days

=== Suicide ===

During the past 12 months, did you ever seriously consider attempting suicide?
A.  Yes
B.  No

During the past 12 months, did you make a plan about how you would attempt suicide?
A.  Yes
B.  No

During the past 12 months, how many times did you actually attempt suicide?
A.  0 times
B.  1 time
C.  2 or 3 times
D.  4 or 5 times
E.  6 or more times

=== Tobacco, alcohol, drugs ===

How old were you when you smoked a whole cigarette or other tobacco/nicotine product for the first
time?
A.  I have never smoked a whole cigarette
B.  8 years old or younger
C.  9 years old
D.  10 years old
E.  11 years old
F.  12 years old
G.  13 years old or older

During the past 30 days, how did you usually get your own cigarettes, or other tobacco/nicotine product?
 (Select all that apply)
A.  I did not smoke cigarettes during the past 30 days
B.  I bought them in a store such as a convenience store, supermarket, discount store, or gas station
C.  I got them on the Internet
D.  I bought them at a public event such as a concert or sporting event
E.  I gave someone else money to buy them for me
F.  A person 18 years old or older gave them to me
G.  I took them from a store
H.  I took them from a family member
I.  I took them from someone else’s home
J.  I got them some other way

During the past 30 days, what is the largest number of alcoholic drinks you had in a 4 hour period?
A.  I did not drink alcohol during the past 30 days
B.  1 or 2 drinks
C.  3 drinks
D.  4 drinks
E.  5 drinks
F.  6 or 7 drinks
G.  8 or 9 drinks
H.  10 or more drinks

During the past 30 days, how many  times did you drive a car or other vehicle when you had been  drinking alcohol?
A.  I did not drive a car or other vehicle during the past 30 days
B.  0 times
C.  1 time
D.  2 or 3 times
E.  4 or 5 times
F.  6 or more times

During the past 30 days, how many times did you use marijuana?
A.  0 times
B.  1 or 2 times
C.  3 to 9 times
D.  10 to 19 times
E.  20 to 39 times
F.  40 or more times

During your life, how many times have you used any form of cocaine, including powder, crack, or freebase?
A.  0 times
B.  1 or 2 times
C.  3 to 9 times
D.  10 to 19 times
E.  20 to 39 times
F.  40 or more times

During your life, how many times have you used heroin (also called smack, junk, or China White)?
A.  0 times
B.  1 or 2 times
C.  3 to 9 times
D.  10 to 19 times
E.  20 to 39 times
F.  40 or more times

During your life, how many times have you taken a prescription drug (such as OxyContin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor's prescription?
A.  0 times
B.  1 or 2 times
C.  3 to 9 times
D.  10 to 19 times
E.  20 to 39 times
F.  40 or more times