Self Screening Tool

Self Screening Tool

Once this form is completed you will be contacted by one of our Intake Specialist to get you connected to the appropriate service.

1. Have you been consistently depressed or down, most of the day, nearly every day, for the past two weeks?

2. In the past two weeks, have you been less interested in most things or less able to enjoy the things you used to enjoy most of the time?

3. Have you felt sad, low, or depressed most of the time for the last two years?

4. In the past month, did you think that you would be better off dead or wish you were dead?

5. Have you ever had a period of time when you were feeling up, hyper, or so full of energy or full of yourself that you got into trouble, or that other people thought you were not your usual self? Do not consider times when you were intoxicated on drugs or alcohol.

6. Have you ever been so irritable, grouchy, or annoyed for several days, that you had arguments, had verbal or physical fights, or shouted at people outside your family?

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