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  • Alcohol and Drug Clinical Evaluation Short Form

    Please complete the form below prior to attending your evaluation meeting. **Confidentiality: The information you give below will be held in strict confidence and will be used for establishing your file. Any misrepresented or false information places you at risk of being re-evaluated (at your cost) or discharged.
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  • Alcohol and Drug History

    Please answer the following questions on the basis of how you have drank alcohol or used drugs in the past 10 years. If you have not been drinking for a length of time, there will be a space to list that in. We need to know how you have drank alcohol or used drugs in the past.

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  • Should be Empty: