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Mental Health and Substance Use Screening Tools  Form

Mental Health and Substance Use Screening Tools Form

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Motivation Negotiated plan Not done Referral recommended. Please help us provide you with the best medical care by answering the questions below. Which recreational drugs have you used in the past year Methamphetamines speed crystal Cocaine Cannabis marijuana pot Narcotics heroin methadone Inhalants paint thinner aerosol glue Hallucinogens LSD mushrooms Tranquilizers valium Other 1. Have you used drugs other than those required for medical reasons No Yes 2. Do you abuse more than one drug at a...
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