{"id":255654,"date":"2026-02-06T17:00:09","date_gmt":"2026-02-06T22:00:09","guid":{"rendered":"https:\/\/screening.mhanational.org\/?post_type=screen&#038;p=255654"},"modified":"2026-03-23T13:08:20","modified_gmt":"2026-03-23T17:08:20","slug":"psychedelics-mental-health-survey","status":"publish","type":"screen","link":"https:\/\/screening.mhanational.org\/es\/screening-tools\/psychedelics-mental-health-survey\/","title":{"rendered":"Encuesta sobre la salud mental y los psicod\u00e9licos"},"content":{"rendered":"<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework full-pager_wrapper' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_92' style='display:none'><form method='post' enctype='multipart\/form-data'  id='gform_92' class='full-pager' class='clearfix' action='\/es\/wp-json\/wp\/v2\/screen\/255654' data-formid='92' novalidate><input id=partial_entry_id_92 class=\"partial_entry_id\" type=hidden name=\"partial_entry_id\" value=\"pending\" data-form_id=\"92\"\/><ol class=\"full-progress-bar clearfix step-1-of-3\"><li class=\"step-1 active\"><span>Survey Questions<\/span><\/li><li class=\"step-2 empty\"><span>Optional Questions<\/span><\/li><\/ol>\n                        <div class='gform-body gform_body'><div id='gform_page_92_1' class='gform_page ' data-js='page-field-id-0' >\n\t\t\t\t\t<div class='gform_page_fields'><div id='gform_fields_92' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_92_173\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_173'>Phone<\/label><div class='gfield_description' id='gfield_description_92_173'>This field is for validation purposes and should be left unchanged.<\/div><div class='ginput_container'><input name='input_173' id='input_92_173' type='text' value='' autocomplete='new-password'\/><\/div><\/div><div id=\"field_92_4\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>New psychedelic medications are being researched as treatment for mental health. This means that psychedelics can be prescribed and possibly covered by health insurance.<\/p>\n<p>This survey was developed to help us explore your opinions about psychedelics and mental health. Sharing these thoughts will help us understand who is interested or not interested in this treatment and which resources and policies we can develop. <strong>No personally identifiable information will be shared outside of MHA.<\/strong><\/p>\n<p>Thank you for participating!<\/p>\n<hr \/><\/div><div id=\"field_92_38\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_38' id='input_92_38' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_39\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_39\" id=\"input_92_39\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"255654\"><\/div><div id=\"field_92_40\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><input name=\"input_40\" id=\"input_92_40\" type=\"hidden\" class=\"gform_hidden\" aria-invalid=\"false\" value=\"f193bd523dbecb7ff45335fb32287682\"><\/div><div id=\"field_92_41\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_41' id='input_92_41' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_51\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_51' id='input_92_51' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_81\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_81' id='input_92_81' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_82\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_82' id='input_92_82' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_83\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_83' id='input_92_83' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_93\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_93' id='input_92_93' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='' \/><\/div><\/div><div id=\"field_92_172\" class=\"gfield gfield--type-hidden gfield--input-type-hidden gfield--width-full gform_hidden field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><div class='ginput_container ginput_container_text'><input name='input_172' id='input_92_172' type='hidden' class='gform_hidden'  aria-invalid=\"false\" value='lang--es' \/><\/div><\/div><fieldset id=\"field_92_157\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Have you used any psychedelics now or in the past? Pick one that most represents you.<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_157'>\n\t\t\t<div class='gchoice gchoice_92_157_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='No, and I don&#039;t want to'  id='choice_92_157_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_0' id='label_92_157_0' class='gform-field-label gform-field-label--type-inline'>No, and I don't want to<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_157_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='No, but I would like to'  id='choice_92_157_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_1' id='label_92_157_1' class='gform-field-label gform-field-label--type-inline'>No, but I would like to<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_157_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='Yes, and I would like to try them again'  id='choice_92_157_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_2' id='label_92_157_2' class='gform-field-label gform-field-label--type-inline'>Yes, and I would like to try them again<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_157_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='Yes, but I don&#039;t want to use them again'  id='choice_92_157_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_3' id='label_92_157_3' class='gform-field-label gform-field-label--type-inline'>Yes, but I don't want to use them again<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_157_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_157' type='radio' value='Yes, I use psychedelics regularly'  id='choice_92_157_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_157_4' id='label_92_157_4' class='gform-field-label gform-field-label--type-inline'>Yes, I use psychedelics regularly<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_92_158\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-2 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Which psychedelics did you try or use most often?<\/legend><div class='gfield_description' id='gfield_description_92_158'>Select up to 2. (For this question, we are intentionally leaving out cannabis.)<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_92_158'><div class='gchoice gchoice_92_158_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.1' type='checkbox'  value='Ayahuasca'  id='choice_92_158_1'   aria-describedby=\"gfield_description_92_158\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_1' id='label_92_158_1' class='gform-field-label gform-field-label--type-inline'>Ayahuasca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.2' type='checkbox'  value='DMT'  id='choice_92_158_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_2' id='label_92_158_2' class='gform-field-label gform-field-label--type-inline'>DMT<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.3' type='checkbox'  value='Ibogaine'  id='choice_92_158_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_3' id='label_92_158_3' class='gform-field-label gform-field-label--type-inline'>Ibogaine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.4' type='checkbox'  value='Ketamine'  id='choice_92_158_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_4' id='label_92_158_4' class='gform-field-label gform-field-label--type-inline'>Ketamine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.5' type='checkbox'  value='LSD (acid)'  id='choice_92_158_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_5' id='label_92_158_5' class='gform-field-label gform-field-label--type-inline'>LSD (acid)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.6' type='checkbox'  value='MDMA (ecstasy, molly)'  id='choice_92_158_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_6' id='label_92_158_6' class='gform-field-label gform-field-label--type-inline'>MDMA (ecstasy, molly)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.7' type='checkbox'  value='Mescaline (peyote)'  id='choice_92_158_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_7' id='label_92_158_7' class='gform-field-label gform-field-label--type-inline'>Mescaline (peyote)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.8' type='checkbox'  value='Psilocybin (mushrooms)'  id='choice_92_158_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_8' id='label_92_158_8' class='gform-field-label gform-field-label--type-inline'>Psilocybin (mushrooms)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_158_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_158.9' type='checkbox'  value='Other...'  id='choice_92_158_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_158_9' id='label_92_158_9' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_141\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_141'>What other psychedelic did you try or use most often?<\/label><div class='ginput_container ginput_container_text'><input name='input_141' id='input_92_141' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_159\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-2 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Which psychedelics are you most interested in trying?<\/legend><div class='gfield_description' id='gfield_description_92_159'>Select up to 2. (For this question, we are intentionally leaving out cannabis.)<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_92_159'><div class='gchoice gchoice_92_159_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.1' type='checkbox'  value='Ayahuasca'  id='choice_92_159_1'   aria-describedby=\"gfield_description_92_159\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_1' id='label_92_159_1' class='gform-field-label gform-field-label--type-inline'>Ayahuasca<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.2' type='checkbox'  value='DMT'  id='choice_92_159_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_2' id='label_92_159_2' class='gform-field-label gform-field-label--type-inline'>DMT<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.3' type='checkbox'  value='Ibogaine'  id='choice_92_159_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_3' id='label_92_159_3' class='gform-field-label gform-field-label--type-inline'>Ibogaine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.4' type='checkbox'  value='Ketamine'  id='choice_92_159_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_4' id='label_92_159_4' class='gform-field-label gform-field-label--type-inline'>Ketamine<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.5' type='checkbox'  value='LSD (acid)'  id='choice_92_159_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_5' id='label_92_159_5' class='gform-field-label gform-field-label--type-inline'>LSD (acid)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.6' type='checkbox'  value='MDMA (ecstasy, molly)'  id='choice_92_159_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_6' id='label_92_159_6' class='gform-field-label gform-field-label--type-inline'>MDMA (ecstasy, molly)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.7' type='checkbox'  value='Mescaline (peyote)'  id='choice_92_159_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_7' id='label_92_159_7' class='gform-field-label gform-field-label--type-inline'>Mescaline (peyote)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.8' type='checkbox'  value='Psilocybin (mushrooms)'  id='choice_92_159_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_8' id='label_92_159_8' class='gform-field-label gform-field-label--type-inline'>Psilocybin (mushrooms)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_159_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_159.9' type='checkbox'  value='Other...'  id='choice_92_159_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_159_9' id='label_92_159_9' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_160\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_160'>What other psychedelic are you most interested in trying?<\/label><div class='ginput_container ginput_container_text'><input name='input_160' id='input_92_160' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_161\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What prevents you from using psychedelics?<\/legend><div class='gfield_description' id='gfield_description_92_161'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_92_161'><div class='gchoice gchoice_92_161_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.1' type='checkbox'  value='I don\u2019t know enough about psychedelics'  id='choice_92_161_1'   aria-describedby=\"gfield_description_92_161\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_1' id='label_92_161_1' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know enough about psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.2' type='checkbox'  value='I don\u2019t think people should use drugs'  id='choice_92_161_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_2' id='label_92_161_2' class='gform-field-label gform-field-label--type-inline'>I don\u2019t think people should use drugs<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.3' type='checkbox'  value='I think it could make my mental health worse'  id='choice_92_161_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_3' id='label_92_161_3' class='gform-field-label gform-field-label--type-inline'>I think it could make my mental health worse<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.4' type='checkbox'  value='I\u2019m afraid of becoming addicted'  id='choice_92_161_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_4' id='label_92_161_4' class='gform-field-label gform-field-label--type-inline'>I\u2019m afraid of becoming addicted<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.5' type='checkbox'  value='I\u2019m afraid of a bad experience (bad trip)'  id='choice_92_161_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_5' id='label_92_161_5' class='gform-field-label gform-field-label--type-inline'>I\u2019m afraid of a bad experience (bad trip)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.6' type='checkbox'  value='They are illegal'  id='choice_92_161_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_6' id='label_92_161_6' class='gform-field-label gform-field-label--type-inline'>They are illegal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.7' type='checkbox'  value='I don\u2019t know if it\u2019s safe (because it\u2019s unregulated)'  id='choice_92_161_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_7' id='label_92_161_7' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know if it\u2019s safe (because it\u2019s unregulated)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.8' type='checkbox'  value='I can\u2019t because of my job (e.g. clearance, drug testing)'  id='choice_92_161_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_8' id='label_92_161_8' class='gform-field-label gform-field-label--type-inline'>I can\u2019t because of my job (e.g. clearance, drug testing)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.9' type='checkbox'  value='It\u2019s hard to get even though I want to try them'  id='choice_92_161_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_9' id='label_92_161_9' class='gform-field-label gform-field-label--type-inline'>It\u2019s hard to get even though I want to try them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.11' type='checkbox'  value='They\u2019re too expensive'  id='choice_92_161_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_11' id='label_92_161_11' class='gform-field-label gform-field-label--type-inline'>They\u2019re too expensive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_161_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.12' type='checkbox'  value='Other...'  id='choice_92_161_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_161_12' id='label_92_161_12' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_162\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_162'>What else prevents you from using psychedelics?<\/label><div class='ginput_container ginput_container_text'><input name='input_162' id='input_92_162' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_164\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What prevents you from using psychedelics as much as you&#039;d like?<\/legend><div class='gfield_description' id='gfield_description_92_164'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_92_164'><div class='gchoice gchoice_92_164_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.1' type='checkbox'  value='Nothing, I use psychedelics as much as I&#039;d like to'  id='choice_92_164_1'   aria-describedby=\"gfield_description_92_164\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_1' id='label_92_164_1' class='gform-field-label gform-field-label--type-inline'>Nothing, I use psychedelics as much as I'd like to<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.2' type='checkbox'  value='I don\u2019t know enough about psychedelics'  id='choice_92_164_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_2' id='label_92_164_2' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know enough about psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.3' type='checkbox'  value='I think it could make my mental health worse'  id='choice_92_164_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_3' id='label_92_164_3' class='gform-field-label gform-field-label--type-inline'>I think it could make my mental health worse<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.4' type='checkbox'  value='I\u2019m afraid of becoming addicted'  id='choice_92_164_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_4' id='label_92_164_4' class='gform-field-label gform-field-label--type-inline'>I\u2019m afraid of becoming addicted<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.5' type='checkbox'  value='I\u2019m afraid of a bad experience (bad trip)'  id='choice_92_164_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_5' id='label_92_164_5' class='gform-field-label gform-field-label--type-inline'>I\u2019m afraid of a bad experience (bad trip)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.6' type='checkbox'  value='They are illegal'  id='choice_92_164_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_6' id='label_92_164_6' class='gform-field-label gform-field-label--type-inline'>They are illegal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.7' type='checkbox'  value='I don\u2019t know if it\u2019s safe (because it\u2019s unregulated)'  id='choice_92_164_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_7' id='label_92_164_7' class='gform-field-label gform-field-label--type-inline'>I don\u2019t know if it\u2019s safe (because it\u2019s unregulated)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.8' type='checkbox'  value='I can\u2019t because of my job (e.g. clearance, drug testing)'  id='choice_92_164_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_8' id='label_92_164_8' class='gform-field-label gform-field-label--type-inline'>I can\u2019t because of my job (e.g. clearance, drug testing)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.9' type='checkbox'  value='It\u2019s hard to get even though I want to try them'  id='choice_92_164_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_9' id='label_92_164_9' class='gform-field-label gform-field-label--type-inline'>It\u2019s hard to get even though I want to try them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_11'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.11' type='checkbox'  value='They\u2019re too expensive'  id='choice_92_164_11'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_11' id='label_92_164_11' class='gform-field-label gform-field-label--type-inline'>They\u2019re too expensive<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_164_12'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.12' type='checkbox'  value='Other...'  id='choice_92_164_12'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_164_12' id='label_92_164_12' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_163\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_163'>What else prevents you from using psychedelics as much as you&#039;d like to?<\/label><div class='ginput_container ginput_container_text'><input name='input_163' id='input_92_163' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_165\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-3 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What did or would you use psychedelics for?<\/legend><div class='gfield_description' id='gfield_description_92_165'>Select your top 3.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_92_165'><div class='gchoice gchoice_92_165_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.1' type='checkbox'  value='I was\/am curious'  id='choice_92_165_1'   aria-describedby=\"gfield_description_92_165\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_1' id='label_92_165_1' class='gform-field-label gform-field-label--type-inline'>I was\/am curious<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.2' type='checkbox'  value='I felt or feel pressured to use them'  id='choice_92_165_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_2' id='label_92_165_2' class='gform-field-label gform-field-label--type-inline'>I felt or feel pressured to use them<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.3' type='checkbox'  value='To feel more social - for fun'  id='choice_92_165_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_3' id='label_92_165_3' class='gform-field-label gform-field-label--type-inline'>To feel more social - for fun<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.4' type='checkbox'  value='To reduce my sadness or anxiety'  id='choice_92_165_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_4' id='label_92_165_4' class='gform-field-label gform-field-label--type-inline'>To reduce my sadness or anxiety<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.5' type='checkbox'  value='To recover from trauma'  id='choice_92_165_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_5' id='label_92_165_5' class='gform-field-label gform-field-label--type-inline'>To recover from trauma<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.6' type='checkbox'  value='To have a spiritual or beyond conscious experience'  id='choice_92_165_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_6' id='label_92_165_6' class='gform-field-label gform-field-label--type-inline'>To have a spiritual or beyond conscious experience<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.7' type='checkbox'  value='To boost energy or motivation'  id='choice_92_165_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_7' id='label_92_165_7' class='gform-field-label gform-field-label--type-inline'>To boost energy or motivation<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.8' type='checkbox'  value='To boost creativity (art, music, creative writing)'  id='choice_92_165_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_8' id='label_92_165_8' class='gform-field-label gform-field-label--type-inline'>To boost creativity (art, music, creative writing)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_165_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_165.9' type='checkbox'  value='Other...'  id='choice_92_165_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_165_9' id='label_92_165_9' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_166\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_166'>What else would or did you use psychedelics for?<\/label><div class='ginput_container ginput_container_text'><input name='input_166' id='input_92_166' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_92_167\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-2 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >When thinking about psychedelics and your mental health, which of the following apply most to you?<\/legend><div class='gfield_description' id='gfield_description_92_167'>Select up to 2.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_92_167'><div class='gchoice gchoice_92_167_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.1' type='checkbox'  value='Psychedelics are\/seem more enjoyable than other types of mental health treatment'  id='choice_92_167_1'   aria-describedby=\"gfield_description_92_167\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_1' id='label_92_167_1' class='gform-field-label gform-field-label--type-inline'>Psychedelics are\/seem more enjoyable than other types of mental health treatment<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.2' type='checkbox'  value='I feel safer using psychedelics than using antidepressants or other medications'  id='choice_92_167_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_2' id='label_92_167_2' class='gform-field-label gform-field-label--type-inline'>I feel safer using psychedelics than using antidepressants or other medications<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.3' type='checkbox'  value='I use psychedelics for other reasons, but the emotional benefits are an added bonus'  id='choice_92_167_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_3' id='label_92_167_3' class='gform-field-label gform-field-label--type-inline'>I use psychedelics for other reasons, but the emotional benefits are an added bonus<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.4' type='checkbox'  value='Traditional therapy alone hasn\u2019t worked for me'  id='choice_92_167_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_4' id='label_92_167_4' class='gform-field-label gform-field-label--type-inline'>Traditional therapy alone hasn\u2019t worked for me<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.5' type='checkbox'  value='Traditional therapy isn&#039;t as available for me'  id='choice_92_167_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_5' id='label_92_167_5' class='gform-field-label gform-field-label--type-inline'>Traditional therapy isn't as available for me<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.6' type='checkbox'  value='I\u2019m using traditional treatments and psychedelics'  id='choice_92_167_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_6' id='label_92_167_6' class='gform-field-label gform-field-label--type-inline'>I\u2019m using traditional treatments and psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_167_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.7' type='checkbox'  value='None of the above'  id='choice_92_167_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_167_7' id='label_92_167_7' class='gform-field-label gform-field-label--type-inline'>None of the above<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_92_168\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full traditional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >If psychedelics became medically available (prescribed and covered by insurance), would you be interested in trying them?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_168'>\n\t\t\t<div class='gchoice gchoice_92_168_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='Yes, and having them monitored by a doctor is most important'  id='choice_92_168_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_0' id='label_92_168_0' class='gform-field-label gform-field-label--type-inline'>Yes, and having them monitored by a doctor is most important<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_168_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='Yes, and having it with a guided therapy session is most important'  id='choice_92_168_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_1' id='label_92_168_1' class='gform-field-label gform-field-label--type-inline'>Yes, and having it with a guided therapy session is most important<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_168_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='Yes, but only if they\u2019re affordable'  id='choice_92_168_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_2' id='label_92_168_2' class='gform-field-label gform-field-label--type-inline'>Yes, but only if they\u2019re affordable<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_168_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='I would still use them but not through medical care'  id='choice_92_168_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_3' id='label_92_168_3' class='gform-field-label gform-field-label--type-inline'>I would still use them but not through medical care<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_168_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_168' type='radio' value='No, I still wouldn\u2019t want to try them'  id='choice_92_168_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_168_4' id='label_92_168_4' class='gform-field-label gform-field-label--type-inline'>No, I still wouldn\u2019t want to try them<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_92_169\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full traditional limit-2 field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >What do you think is the most important priority for the government regarding psychedelics today?<\/legend><div class='gfield_description' id='gfield_description_92_169'>Select up to 2.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_92_169'><div class='gchoice gchoice_92_169_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.1' type='checkbox'  value='Ban psychedelics entirely'  id='choice_92_169_1'   aria-describedby=\"gfield_description_92_169\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_1' id='label_92_169_1' class='gform-field-label gform-field-label--type-inline'>Ban psychedelics entirely<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.2' type='checkbox'  value='Make psychedelics legal'  id='choice_92_169_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_2' id='label_92_169_2' class='gform-field-label gform-field-label--type-inline'>Make psychedelics legal<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.3' type='checkbox'  value='Create a regulated recreational market for psychedelics'  id='choice_92_169_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_3' id='label_92_169_3' class='gform-field-label gform-field-label--type-inline'>Create a regulated recreational market for psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.4' type='checkbox'  value='Make medically available psychedelics accessible (FDA approval)'  id='choice_92_169_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_4' id='label_92_169_4' class='gform-field-label gform-field-label--type-inline'>Make medically available psychedelics accessible (FDA approval)<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.5' type='checkbox'  value='Make medical psychedelics more affordable'  id='choice_92_169_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_5' id='label_92_169_5' class='gform-field-label gform-field-label--type-inline'>Make medical psychedelics more affordable<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.6' type='checkbox'  value='Invest in more research on psychedelics'  id='choice_92_169_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_6' id='label_92_169_6' class='gform-field-label gform-field-label--type-inline'>Invest in more research on psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.7' type='checkbox'  value='Invest in public education on using psychedelics'  id='choice_92_169_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_7' id='label_92_169_7' class='gform-field-label gform-field-label--type-inline'>Invest in public education on using psychedelics<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_92_169_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_169.8' type='checkbox'  value='Other...'  id='choice_92_169_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_92_169_8' id='label_92_169_8' class='gform-field-label gform-field-label--type-inline'>Other...<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_170\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_170'>What else do you think is the most important priority for the government regarding psychedelics today?<\/label><div class='ginput_container ginput_container_text'><input name='input_170' id='input_92_170' type='text' value='' class='medium'    placeholder='Tell us more...'  aria-invalid=\"false\"   \/><\/div><\/div><\/div>\n                    <\/div>\n                    <div class='gform-page-footer gform_page_footer top_label'>\n                         <input type='button' id='gform_next_button_92_17' class='gform_next_button gform-theme-button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='next' value='Next'  \/> \n                    <\/div>\n                <\/div>\n                <div id='gform_page_92_2' class='gform_page demographics' data-js='page-field-id-17' style='display:none;'>\n                    <div class='gform_page_fields'>\n                        <div id='gform_fields_92_2' class='gform_fields top_label form_sublabel_below description_above validation_below'><div id=\"field_92_171\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><p>Please take a moment to answer the following <strong>optional<\/strong> questions. Your answers are totally anonymous\u2014we won't be able to identify you based on this information. Your answers help us provide better information and support for people like you.<\/p>\n\n<p>You can answer as many or as few questions as you would like. When you are done, scroll to the bottom of the survey and click \"submit\".<\/p><\/div><div id=\"field_92_53\" class=\"gfield gfield--type-html gfield--input-type-html section-title gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><h2>About You<\/h2><\/div><div id=\"field_92_54\" class=\"gfield gfield--type-select gfield--input-type-select optional taxonomy field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_54'>Age Range<\/label><div class='ginput_container ginput_container_select'><select name='input_54' id='input_92_54' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Under 18' >Under 18<\/option><option value='18-24' >18-24<\/option><option value='25-34' >25-34<\/option><option value='35-44' >35-44<\/option><option value='45-54' >45-54<\/option><option value='55-64' >55-64<\/option><option value='65+' >65+<\/option><option value='Prefer not to answer' >Prefer not to answer<\/option><\/select><\/div><\/div><fieldset id=\"field_92_55\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio optional mb-2 short field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gender<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_55'>\n\t\t\t<div class='gchoice gchoice_92_55_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Female'  id='choice_92_55_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_55_0' id='label_92_55_0' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_55_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Male'  id='choice_92_55_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_55_1' id='label_92_55_1' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_55_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Non-Binary'  id='choice_92_55_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_55_2' id='label_92_55_2' class='gform-field-label gform-field-label--type-inline'>Non-Binary<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_55_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_55' type='radio' value='Prefer not to answer'  id='choice_92_55_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_55_3' id='label_92_55_3' class='gform-field-label gform-field-label--type-inline'>Prefer not to answer<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_92_156\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you identify as transgender?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_156'>\n\t\t\t<div class='gchoice gchoice_92_156_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='Yes'  id='choice_92_156_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_156_0' id='label_92_156_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_156_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='No'  id='choice_92_156_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_156_1' id='label_92_156_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_135\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_135'>How would you describe your gender?<\/label><div class='ginput_container ginput_container_text'><input name='input_135' id='input_92_135' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_92_58\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_58'>Race\/Ethnicity<\/label><div class='ginput_container ginput_container_select'><select name='input_58' id='input_92_58' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='American Indian or Alaska Native' >American Indian or Alaska Native<\/option><option value='Asian' >Asian<\/option><option value='Black or African American (non-Hispanic)' >Black or African American (non-Hispanic)<\/option><option value='Hispanic or Latino' >Hispanic or Latino<\/option><option value='Middle Eastern or North African' >Middle Eastern or North African<\/option><option value='Native Hawaiian or other Pacific Islander' >Native Hawaiian or other Pacific Islander<\/option><option value='White (non-Hispanic)' >White (non-Hispanic)<\/option><option value='More than one of the above' >More than one of the above<\/option><option value='Other...' >Other...<\/option><\/select><\/div><\/div><div id=\"field_92_134\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_134'>How would you describe your race\/ethnicity?<\/label><div class='ginput_container ginput_container_text'><input name='input_134' id='input_92_134' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_92_59\" class=\"gfield gfield--type-select gfield--input-type-select optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_59'>Household Income<\/label><div class='ginput_container ginput_container_select'><select name='input_59' id='input_92_59' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Less than $20,000' >Less than $20,000<\/option><option value='$20,000 - $39,999' >$20,000 - $39,999<\/option><option value='$40,000 - $59,999' >$40,000 - $59,999<\/option><option value='$60,000 - $79,999' >$60,000 - $79,999<\/option><option value='$80,000 - $99,999' >$80,000 - $99,999<\/option><option value='$100,000 - $149,999' >$100,000 - $149,999<\/option><option value='$150,000+' >$150,000+<\/option><\/select><\/div><\/div><fieldset id=\"field_92_87\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Do you live in the United States or another country?<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_92_87'>\n\t\t\t<div class='gchoice gchoice_92_87_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='I live in the United States'  id='choice_92_87_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_87_0' id='label_92_87_0' class='gform-field-label gform-field-label--type-inline'>I live in the United States<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_92_87_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_87' type='radio' value='I live in another country'  id='choice_92_87_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_92_87_1' id='label_92_87_1' class='gform-field-label gform-field-label--type-inline'>I live in another country<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_92_78\" class=\"gfield gfield--type-select gfield--input-type-select gfield--width-full optional field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_92_78'>State<\/label><div class='ginput_container ginput_container_select'><select name='input_78' id='input_92_78' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' >Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' 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