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| 1. How troubled or bothered are you by the medical problems in the past 30 days?(Do not include ailments directly caused by drugs/alcohol unless ailments related to drugs/alcohol would persist if the clt were abstinent i.e: cirrhosis, abscesses) |
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| 2. How troubled or bothered are you by the employment/education problems in the past 30 days?How often do you conduct surveys? |
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| 3. How troubled or bothered are you by the social connectedness problems in the past 30 days?How often do you conduct surveys? |
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| 4. How troubled or bothered are you by the alcohol/drug problems in the past 30 days? |
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| 5. How troubled or bothered are you by the legal problems in the past 30 days? |
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| 6. How troubled or bothered are you by the familial/social problems in the past 30 days? |
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| 7. How troubled or bothered are you by the psychological/emotional problems in the past 30days? |
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| 8. How troubled or bothered are you by the problems in your living environment the past 30 days? |
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| 9. How troubled or bothered are you by the problems with access to service in the past 30 days? |
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