Assessment

Name* Email* Are you experiencing anxiety or stress that keeps you from functioning as you would like? - Yes No Do you feel overwhelmed by responsibilities in your life? - Yes No Do you have any difficulties with relationships in your life? - Yes No Are you feeling depression concerning your life? - Yes No Do you feel that you need alcohol or drugs helps you cope? - Yes No Do you have financial stresses? - Yes No Are you unemployed or underemployed? - Yes No Would you like to have goals for change in the next year? - Yes No

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