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The Overdose Safety Planning Intervention: Clinical Tools and Support Materials January 2022www. ZeroOverdose.writhe Overdose Risk Screening Form While all use of substances come with some risk, we

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How to fill out overdose risk self-assessment a

01

Begin by reading each question on the overdose risk self-assessment form carefully.

02

Answer each question truthfully and to the best of your knowledge.

03

Make sure to consider your current substance use habits and any past history of substance abuse.

04

If you are unsure about how to answer a question, seek guidance from a healthcare professional or counselor.

05

Once you have completed the self-assessment, review your answers and consider seeking help if you are at risk of overdose.

Who needs overdose risk self-assessment a?

01

Individuals who have a history of substance abuse or are currently using drugs or alcohol.

02

People who are concerned about their risk of overdose and want to assess their current situation.

03

Healthcare providers who are working with patients at risk of overdose and want to assess their risk levels.

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What is overdose risk self-assessment a?

Overdose risk self-assessment a is a tool designed to evaluate an individual's risk of overdose, taking into account various factors such as substance use history and health conditions.

Who is required to file overdose risk self-assessment a?

Individuals who are prescribed controlled substances or those engaged in substance use treatment programs are typically required to file overdose risk self-assessment a.

How to fill out overdose risk self-assessment a?

To fill out overdose risk self-assessment a, individuals must provide information about their medication use, substance use history, and any relevant medical conditions as instructed in the assessment form.

What is the purpose of overdose risk self-assessment a?

The purpose of overdose risk self-assessment a is to identify individuals at risk for overdose, enabling healthcare providers to intervene appropriately and provide support or treatment.

What information must be reported on overdose risk self-assessment a?

Information required on overdose risk self-assessment a typically includes personal details, medication and substance use history, and any previously experienced overdose incidents.

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