PLEDGE FORM

Fill in this Pledge Form to make your pledge official!

But before you do, please tell us: whether your answers can be included in a Brock study of CopeCareConnect.ca



About the
Study

Click here for complete info about the study

I picked this pledge to… strongly
disagree
strongly
agree
prefer not
to answer
help me cope with things in my life
show others I care about them
make my institution a better place to be

In the past month, I… not at all once or twice
altogether
some days
each week
every day or
almost every day
prefer not
to answer
drank alcohol
vaped nicotine
smoked cigarettes
used cannabis
used other recreational drugs
took prescribed medication for mental health concerns
Please add me to the CopeCareConnect email list to receive updates & invites 5-6times/year.

Please submit your answers