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SUBSTANCE ABUSE ASSESSMENT FORM Please make copies as needed and please type or print legibly. Instructions for use: Complete this form and use these questions to guide the EAP client interview when
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How to fill out substance abuse assessment form

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How to fill out a substance abuse assessment form:

01
Begin by carefully reading and understanding the instructions provided on the form. Pay attention to any specific requirements or information that needs to be included.
02
Start with personal information section, which usually includes your name, contact details, date of birth, and address. Provide accurate and up-to-date information to ensure the assessment is properly documented.
03
Proceed to the section that asks about your substance abuse history. This may include questions about the types of substances you have used, the frequency and duration of use, and any previous treatment or rehab programs you have undergone. Be honest and provide as much detail as possible to help the assessors understand your situation accurately.
04
In the next section, you may be asked about the impact of substance abuse on your daily life. This can include questions about the effects on your relationships, work or school performance, physical and mental health, and legal issues. Again, be open and thorough in your responses, as it will aid in determining the appropriate assistance and treatment options.
05
The form may also have sections dedicated to assessing your readiness for change, motivation levels, and willingness to seek treatment. Answer these questions honestly and reflect upon your own thoughts and feelings regarding your substance abuse.
06
Some forms might include a section for additional comments or explanations. Use this space to provide any additional information that you deem important or relevant to your situation. This could include any mitigating factors or challenges you face in combating substance abuse.

Who needs a substance abuse assessment form:

01
Individuals seeking assistance or treatment for substance abuse may need to complete a substance abuse assessment form. This form helps healthcare professionals, counselors, or treatment providers gain a comprehensive understanding of the individual's substance abuse history, its impact on their life, and their readiness for change.
02
In some cases, employers or educational institutions may require individuals to undergo a substance abuse assessment as part of their hiring process or to comply with certain policies. This is often done to ensure the safety and well-being of both the individual and those around them.
03
Law enforcement agencies may also utilize substance abuse assessment forms to evaluate individuals involved in legal matters related to substance abuse. This can aid in determining appropriate legal interventions or treatment recommendations.
It is important to fill out the substance abuse assessment form accurately and honestly to receive appropriate care and support tailored to individual needs.
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Substance abuse assessment form is a document used to evaluate and gather information about an individual's history of substance abuse.
Individuals who have a history of substance abuse or are seeking help for substance abuse are required to file the form.
The form can be filled out by providing accurate and truthful information about one's substance abuse history and current situation.
The purpose of the form is to assess the extent of an individual's substance abuse problem and determine the appropriate course of action or treatment.
Information such as type and frequency of substance use, past treatment history, and any related medical or mental health issues must be reported on the form.
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