Care Quiz

If you are thinking about asking for help, this short quiz can determine if treatment is the next step for you.

Submitting this form gives us permission to reach out through email or phone. If you are experiencing a medical emergency, please call 911.

When thinking about substance or alcohol use over the past 3 months (include prescription drug use other than prescribed):

Cut Down: Have you felt you should cut down your intake of drugs and/or alcohol?

YesNo

Angry: Do you get angry when people tell you to overuse drugs and/or alcohol?

YesNo

Regret: Have you ever felt regret or guilt about your drug and/or alcohol use?

YesNo

Essential: Do you need drugs and/or alcohol to get over a hangover or get going in the am?

YesNo

First Name*

Last Name

Phone

Email*

By providing your name, email address, and/or phone number, you are giving us permission to follow up with you about your results to the CARE quiz.

Thank you for taking the CARE Quiz

We have sent the results to your email.

If you are experiencing a medical emergency, please call 911.

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