Do I Need Addiction Counselling? Self-Check by Sana Psychological.

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Are you engaging with behaviours and/or substances to an extent that you feel is harmful?* This field is required.

YESNO

2

Have you experienced changes to your eating, hygiene and/or sleeping habits as a result of substance use or problem behaviours?* This field is required.

YESNO

3

In recent months have you been sad, down, blue and/or numb the majority of the time or significantly more than usual?* This field is required.

YESNO

4

Have you noticed you need more of a substance or behaviour to feel the same high and/or have switched to something new to find this?* This field is required.

YESNO

5

Have other people expressed concern about your substance use or behavioural patterns?* This field is required.

YESNO

6

Are your daily thoughts and/or routines revolving around substance use and/or behaviours that you wish to engage in?* This field is required.

YESNO

7

Do you describe yourself as an impulsive person?* This field is required.

YESNO

8

Have you experienced consequences in your life (professional, relational, personal, health, financial, and/or legal) as a result of substance use or problem behaviours?* This field is required.

YESNO

9

Have you been trying to abstain or moderate a behaviour and find that you can’t?* This field is required.

YESNO

10

Do you identify as having addiction or an 'addictive personality'?* This field is required.

YESNO

11

Do you experience thoughts and/or cravings for a substance(s) or problem behaviour(s)?* This field is required.

YESNO

12

Have you noticed that you are doing less of the things that you enjoy in recent months or years?* This field is required.

YESNO

13

Do you not experience as much joy from life as you used to?* This field is required.

YESNO

14

What is your email? We'll send you more info.* This field is required.This is not a substitute for professional assessment or diagnosis. You may receive recommendations & free resources from Sana Psyc; you are free to unsubscribe at any time.

example@example.com

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Calculation

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Sorry :( This form is only availble in Canada

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