Behavioral Health Check-in Forms

CAGE-AID Questionnaire
When thinking about drug use, include illegal drug use and the use of prescription drug use other than prescribed.
1. Have you ever felt you ought to cut down on your drinking or drug use?*

YesNo
2. Have people annoyed you by criticizing your drinking or drug use?*

YesNo
3. Have you ever felt bad or guilty about your drinking or drug use?*

YesNo
4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover?*

YesNo
Should be Empty:

Behavioral Health Check in Forms