ASI Self-Report Form - Center for Health Care Evaluation - chce research va 2026

1. Click ‘Get Form’ to open the ASI Self-Report Form in the editor.
2. Begin with Part I: Your Background and Employment. Fill in your birth date, marital status, and answer questions regarding your employment history by placing an 'X' in the appropriate boxes or writing in the required information.
3. Move to Part II: Your Health. Record any medical problems experienced in the past 30 days and indicate how these have affected you. Be sure to answer all questions about psychological issues honestly.
4. Proceed to Part III: Your Family Relationships. Reflect on any conflicts with family members and indicate how these have impacted you emotionally.
5. In Part IV: Your Alcohol and Drug Use, document your usage patterns over the past month, including frequency and any related problems.
6. Finally, complete Part V: Your Legal Situation by answering questions about any legal issues you may be facing.

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