Call 24 hours a day, General Information: 520-770-1880.
Toll Free: 1-877-770-1881, Admission: 520-977-8996.

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Helping Women Find Their Way to Health and Wholeness

Am I addicted to drugs? Free drug abuse assessment

Please complete the following form and click Submit. We will contact you as soon as possible regarding the results. Are you interested in taking our alcohol abuse assessment?

Fields marked * are required.

Your Name:

Email Address: *

Phone Number:

Are you unhappy with the way your life is going?:

Yes

No

Do you feel you may have a problem with drugs?:

Yes

No

Are you preoccupied with thoughts of using drugs?:

Yes

No

Can you stop using drugs on your own?:

Yes

No

Do you use drugs continuously?:

Yes

No

Do you use more than one drug at a time?:

Yes

No

Are drugs causing problems with your job?:

Yes

No

Have your relationships been negatively affected?:

Yes

No

Do you refuse to go places where you cannot use drugs?:

Yes

No

Do you need to use drugs to have fun socially?:

Yes

No

Do you do things that are illegal to get drugs?:

Yes

No

Do you hide drugs from family or friends?:

Yes

No

Do you lie about using drugs?:

Yes

No

Do you use drugs to escape your problems?:

Yes

No

Have you had medical problems from using drugs?:

Yes

No

Has drug use resulted in legal problems?:

Yes

No

Do you worry that friends or family know you use drugs?:

Yes

No

Do you have withdrawal when you cannot get drugs?:

Yes

No

Do you ever crave drugs?:

Yes

No

Do you use drugs to cope with fear or anger or depression?:

Yes

No

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Call 24 hours a day, General Information:: 520-770-1880
Toll Free:: 1-877-770-1881, Admission:: 520-977-8996
100 S. Avenida de Palmas :: Tucson, Arizona 85716
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