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About Us
Important Things To Know
Our Clinical Team
Our Support Team
Mission Vision Values
Our Environment
Careers
Assessments
Adults
Children
Teens
Psychotherapy
Adults
Teens
Children
Workshops
New Clients
Our Promise to You
Quick 1st Appointment
Our Clinical Approach
What to Expect
Virtual Services
Fees + Coverage
FAQs
Resources
Videos
Articles
Infographics
Questionnaire
Contact
Adult Addictions Questionnaire
Answer each question, then click submit to see your results.
Adult Addiction Mini-Questionnaire
Taken prescription medication for unintended purposes
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Abused alcohol and/or substances
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Have consistently consumed more than 5 drinks for males (or 4 for females) in one sitting
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Drank alcohol for the purpose of getting drunk
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Drank, used marijuana, or consumed an illicit substance as a means of coping with stress
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Blacked out or was unable to remember events after drinking or using substances
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Hid use of alcohol and/or substances
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Alcohol or substance use caused negative consequences at home and/or work or an increase in risky behaviours (e.g., arguments with loved ones, driving a vehicle while intoxicated, etc.)
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Feeling bad/guilty about your use of alcohol and/or substances
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Tried to cut back on your alcohol and/or substance use, but failed
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Lost large sums of money through gambling
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Had problems at home or work as a result of gambling
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Experienced cravings or withdrawal symptoms when not using alcohol/substances (e.g., anxiety, headache, nausea, fatigue, restlessness, depression, muscle pain, fever, etc.)
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Required more alcohol/substances to experience the same desired effect
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Needed alcohol/substances in order to have fun (e.g., during a social outing)
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
Tried unsuccessfully to reduce Internet, videogame, gambling, pornography and/or TV watching
*
Not at all / Never
A little bit / Slightly
Somewhat / Moderate
Quite a bit / Often
Extremely
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