DAST Please enable JavaScript in your browser to complete this form.Clients Code *Email *If you have difficulty with a statement, then choose the response that is mostly right.1. Have you used drugs other than those required for medical reasons? *yesno2. Do you abuse more than one drug at a time? *yesno3. Are you always able to stop using drugs when you want to? (If never use drugs, answer “Yes.” *yesno4. Have you had "blackouts" or "flashbacks" as a result of drug use? *yesno5. Do you ever feel bad or guilty about your drug use? If never use drugs, choose “No.” *yesno6. Does your spouse (or parents) ever complain about your involvement with drugs? *yesno7. Have you neglected your family because of your use of drugs? *yesno8. Have you engaged in illegal activities in order to obtain drugs? *yesno spouse 4. of 9. Have you ever experienced withdrawal symptoms (felt sick) when you stopped taking drugs? *yesno10. Have you had medical problems as a result of your drug use (e.g., memory loss, hepatitis, convulsions, bleeding, etc.)? *yesnoSubmit
