Assist Questionnaire

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PDF ASSIST QUESTIONNAIRE a – KePRO – ASSIST QUESTIONNAIRE a Client ID: o-ol ic s d. e e. s f. ive a g.-s h. in i. s j. y 1. In your life, which of the following substance(s) have you ever used? 1 1 1 1 1 1 1 1 1 1 2. In the past three months, how often have you used the substances you mentioned? N EVER ONCE OR TWICE MONTHLY WEEKLY DAILY OR ALMOST DAILY

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ASSIST Questionnaire – SBIRT@IUSM – The ASSIST is one of the longer screening tools and can take as long as 10 minutes to complete; it covers alcohol, tobacco, and illicit drugs rather than just alcohol. Brief 8 question screening questionnaire that is self administered or done via interview.