Drug & Alcohol Addiction - Admission Questionnaire Rehabguide

Admission Questionnaire

Admission Questionnaire

The admission process

As you begin your journey towards drug and alcohol recovery, the first step is a professional assessment. Before drug & alcohol addiction treatment begins, addiction professionals must better understand your physical and mental state to make your recovery experience smoother and more effective.

To begin, our staff will ask you a series of questions relating to your demographic information, details of substance use, history of any withdrawal symptoms, and mental health conditions. , The intake process is your time to communicate any concerns and to help a recovery centre gain an accurate picture of your dependency issues, lifestyle and background.

Am I addicted enough to be admitted?

Having come this far, by just being here, you may have answered your own question. Look through the symptoms below and ask yourself; is it worth it? Just to have a drink?

  • Increase or decrease in appetite, changes in eating habits, unexplained weight loss/gain.
  • The smell of substance on breath, body or clothes.
  • Difficulty in paying attention, forgetfulness.
  • Changes in attitude/personality with no obvious cause or explanation.
  • Changes in behaviour, loss of interest in family and family activities.
  • Changes in personal grooming habits.
  • Vomiting, toilet problems.
  • Difficulty sleeping.
  • Extreme hyperactivity, excessive talking.
  • Increased smoking, nail-biting.
  • Tasks that were once easy are difficult or neglected.
  • Hiding alcohol in the house/ car/ workplace, etc.
  • Defensiveness, bad temper, restless behaviour.
  • Unexplained moodiness, irritability or nervousness.
  • Violent temper.
  • Unexplained silliness or giddiness, bizarre behaviour.
  • Car accidents, household accidents.
  • Scrapes, scratches, bumps, bruises.
  • A new crowd of friends, new hang-outs, avoiding old friends.
  • Friends who are heavy-drinkers or drug-users.
  • Lack of motivation/energy, poor discipline, boredom, ‘I don’t care’ attitude.
  • Paranoia, suspiciousness.
  • Excessive need for privacy, keeping doors locked/closed.
  • Secretive or suspicious behaviour.
  • Unexplained need for money, can’t explain where the money goes, stealing.
  • Chronic dishonesty, trouble with the police.
  • Needle-marks or bruises on lower arms, legs or soles of feet.
  • Unusual efforts to cover arms or legs.
  • Possession of drug paraphernalia.
  • Low self-esteem, low self-worth.
  • Depressive moods/feelings.
  • Feelings of powerlessness or resignation.
  • Thoughts of self-harming, thoughts of suicide, thoughts of ‘ending it all’.
  • Self-harming.

Try a self-assessment

Self Assessment

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