CAGE-AID: Substance USE Screening

Your Name*

Email

Date*

Intended Therapist*

1. Have you felt you ought to cutdown on your drinking or drug use?*

2. Have people annoyed you by criticizing your drinking or drug use?*

3. Do you feel bad or guilty about your drinking or drug use?*

4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves, get rid of a hangover or get the day started?*