Self Assessment Quiz

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Self Assessment Quiz

If you are not sure whether you have a drinking problem or an addiction to drugs or prescription pills, this Addiction Self Assessment form can help. For best results, be honest with your answers. And remember, your self assessment is completely private.

This field is for validation purposes and should be left unchanged.

First name(Required)

Last name(Required)

Email(Required)

Phone(Required)

Which Location Would You Be Interested In?(Required)

Reno, NV

Northern California

1. How often have you tried to cut down on your drinking or using?(Required)

Often

Sometimes

Rarely

Never

2. How often have you been annoyed when confronted about your drinking or using?(Required)

Often

Sometimes

Rarely

Never

3. How often have you felt guilty because of your drinking or using?(Required)

Often

Sometimes

Rarely

Never

4. How often have you had something to drink or used first thing in the morning?(Required)

Often

Sometimes

Rarely

Never

5. How often has your drinking or using caused you problems with family or friends?(Required)

Often

Sometimes

Rarely

Never

6. How often does your spouse/parents/significant other complain about your using or drinking?(Required)

Often

Sometimes

Rarely

Never

7. How often have you ever felt sick when you’ve stopped drinking or using?(Required)

Often

Sometimes

Rarely

Never

8. How often are you preoccupied with drinking or using, thinking of it while you're doing other things, on the job, etc.?(Required)

Often

Sometimes

Rarely

Never

9. How often do you wonder if you have a drug or alcohol problem?(Required)

Often

Sometimes

Rarely

Never

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Admitting and understanding that you may have an addiction that needs intervention is the first step in your journey to recovery. Take our confidential self assessment quiz.