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WebEAP EFT Form (PDF 100K) – to request electronic funds transfer to your bank account. Auxiliary Forms (use as needed) Substance Abuse/Chemical Dependency Assessment (PDF) If your assessment or the result of the chemical dependency (CD) screening indicates a possible CD issue, the Substance Abuse/Chemical Dependency Assessment form must … WebDrug Abuse Screening Test (DAST) Adults A 20- and 28-item adaptation of the Michigan Alcohol Screening Test (MAST) to detect consequences related to drug abuse without … home goods at the legends

Conducting Intake Effectively: 22 Forms, Questions, & Apps - Intake …

WebThe AUDIT questionnaire is designed to help in the self-assessment of alcohol consumption and to identify any implications for the person's health and wellbeing, now and in the future. It consists of 10 questions on alcohol use. The responses to these questions can be scored and the total score prompts feedback to the person and in some cases ... WebAn alcohol and drug evaluation form is used in drug rehabilitation centers to complete a psychological evaluation of a patient suffering from addiction. Rehab centers need a form … WebPage 1 of 4 Better Mood Clinic, P. C. 2935 N. Ashley St. Bldg F Valdosta, GA 31602 Substance Abuse Intake All information on this form is strictly confidential homegoods at the rim san antonio