Risk Assessment | DentaQuest

Do you have a history of alcohol or drug problems? Yes No

Do you have a parent or guardian with alcohol or drug problems? Yes No

Are you under age 21 or over age 65? Yes No

Have you had a traumatic event in your life as a child or adult? Yes No

Have you ever had an opioid overdose? Yes No

Do you have mental health challenges? (depression, anxiety, bipolar disorder, schizophrenia, PTSD, etc.)? Yes No

Do you have trouble finding a place to live? Yes No

Do you have trouble finding food for you or your family? Yes No

Opioid Risk Assessment