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Do you drink alcohol more than once a week No 9. How often do you engage in recreational drug use Daily Weekly Infrequently Monthly Never 10. If yes please indicate the family member s relationship to you in the space provided father grandmother uncle Please Circle Alcohol/Substance Abuse yes/no Anxiety Depression Domestic Violence Eating Disorders Obesity Obsessive Compulsive Behavior Schizophrenia Suicide Attempts List Family Member ADDITIONAL INFORMATION If yes what is your current...
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