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Alcohol Drug Abuse Questionnaire Name Sex M F Height Weight Date of Birth Smoker? Y N State Coverage Desired? Amount Plan Desired? Do you presently use alcoholic beverages? Y N If Yes, Please advise:.

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The CAGE can identify alcohol problems over the lifetime. Two positive responses are considered a positive test and indicate further assessment is warranted.

The CAGE Assessment (also called the CAGE Questionnaire) is a preliminary test. It's a set of questions that are used to show you may have a substance abuse dependency in adults. The letters CAGE stand for Cut, Annoyed, Guilty, and Eye, based on the questions that can help tell if you have a substance abuse problem.

The CAGE questionnaire consists of four questions that relate to your use of alcohol: Have you ever felt that you ought to C ut down on your drinking? Do you get A nnoyed by criticism of your drinking? Do you ever feel G uilty about your drinking?

The CAGE Assessment (also called the CAGE Questionnaire) is a preliminary test. It's a set of questions that are used to show you may have a substance abuse dependency in adults. The letters CAGE stand for Cut, Annoyed, Guilty, and Eye, based on the questions that can help tell if you have a substance abuse problem.

The CAGE is a 4-item, relatively nonconfrontational questionnaire for detection of alcoholism, usually phrased as "have you ever" but may be focused to delineate past or present alcohol problems.

“Have you ever drank alcohol?” or “Have you ever used any drugs or Cannabis?” This can then be followed up by asking “How often do you use?”, “How much do you use?”, and “How do you use?” if appropriate.

Have you ever felt you needed to Cut down on your drinking? Have people Annoyed you by criticizing your drinking? Have you ever felt Guilty about drinking? Have you ever felt you needed a drink first thing in the morning (Eye-opener) to steady your nerves or to get rid of a hangover?

Screening tool that identifies alcohol, drug use and substance-related driving risk among adolescents and young adults. Parents, Partners, Past and Pregnancy (The 4Ps) Screening tool developed to detect dug, alcohol, and tobacco use among pregnant women and women of childbearing age.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232