About Someone Else Please answer these questions open and honestly to give an accurate result. Results or answers are not saved or shared with any outside organisation and are fully confidential . In the past 3 months how many times have they failed to attend an appointment or commitment including work?(Required) 0 1-3 times 4-6 times 7-10 times 10 times or more I don't know In the past 30 days how many days have they drank or used?(Required) 0 1-4 5-10 11-17 18-25 25 days or more I don't know In the past 30 days what percentage of phones calls have they not answered or returned the call that day?(Required) They always answer They don’t answer roughly 25% of the time They don’t answer roughly 50 % of the time They don’t answer roughly 75 % of the time They never answer In you opinion, their personal hygiene standards have decreased since you thought there maybe a problem?(Required) Strongly Disagree Disagree noticed no change/neither agree or disagree Agree Strongly Agree The person is dishonest about their drinking or using?(Required) Strongly Disagree Disagree Neutral Agree Strongly Agree When they drink or use, they have more then they promise or say they will?(Required) Strongly Disagree Disagree Neutral Agree Strongly Agree How open is the person when it comes to talking about their drinking or using?(Required) They are open and honest and I feel they are telling the truth They will talk about it but not in detail They deflect the conversation I cannot talk about it with the person They are open and honest and they want help In your opinion, they are isolating from society?(Required) Strongly Disagree Disagree Neutral Agree Strongly Agree
